Low sensitivity of the electrocardiogram in diagnosis of hypertensive left ventricular hypertrophy

Abstract

Clinical recognition of hypertensive cardiac involvement depends primarily on the use ofnoninvasive methods. Although electrocardiography is the usual method of identifying left ventricular hypertrophy on routine evaluations, the electrocardiogram detects only a small percentage of the instances of left ventricular hypertrophy that are documented by echocardiograms. This study investigated the diagnostic accuracy of Romhilt-Estes criteria in diagnosing left ventricular hypertrophy in hypertensive patients and to assess the impact of age, sex, blood pressure level, and patterns of left ventricular geometry on the diagnostic accuracy of electrocardiography for detecting left ventricular hypertrophy. Of the 169 hypertensive subjects, electrocardiographic left ventricular hypertrophy was present in 26 (15 %). The overall sensitivity of the Romhilt- Estes criteria in the diagnosis of left ventricular hypertrophy was 26%, spesificity was 96% and overall diagnostic accuracy was 55%. In conclusion, we found that the sensitivity of elect-rocardiography for left ventricular hypertrophy was low, even when blood pressure level, age, sex, and patterns of left ventricular geometry were taken into consideration.