CORRELATION BETWEEN ELECTROCARDIOGRAM AND ECHOCARDIOGRAPHY IN THE ASSESSMENT OF LEFT VENTRICULAR HYPERTROPHY AMONG HYPERTENSION PATIENTS

BACKGROUND \nIn routine clinical practice, the electrocardiogram (ECG) is usually the first method used for diagnosing LVH using various criteria. \nThese ECG criteria generally had shown high specificities and low sensitivity in diagnosing LVH. However, their low sensitivities \ndo not mean that it excludes the presence of LVH. \nThe aim of this study was to assess the validity of ECG by comparing it with echocardiogram in diagnosing LVH among \nhypertension patients. \nMATERIALS AND METHODS \nA prospective longitudinal study was conducted at our hospital for a period of six months among 100 patients with hypertension. \nThe study was started after getting the clearance from the institutional ethical committee. Twelve lead electrocardiography was \ndone with GE electrocardiogram machine. Twelve leads electrocardiography was recorded at the paper speed of 25 mm/second \nand calibration of 10mm was taken as a standard electrocardiogram. Electrocardiographic criteria used to diagnose left \nventricular hypertrophy were Romhilt – Estes Point Score and Sokolow and Lyon Voltage Criteria and total QRS voltage criteria. \nLater, on all these patients, M-mode echocardiography was performed using Esoate Mylab Five machine. Person performing \nEcho was blinded to electrocardiographic findings. \nRESULTS \nThe validity of the various ECG criteria in diagnosing LVH in comparison with echocardiogram shows that all the validity \nparameters like sensitivity, specificity, positive predictive value, negative predictive value and accuracy was found to be high for \ntotal QRS criteria than that of Sokolow-Lyon and Romhilt Estes criteria and the difference was also found to be statistically \nsignificant. The correlation r value was found to be equal to or less than 0.5 for Sokolow-Lyon and Romhilt Estes criteria, \nwhereas for total QRS the R value was greater than 0.6 but for none of the criteria the P value was found to be statistically \nsignificant. \nCONCLUSION \nEchocardiography is definitely a better tool in the detection of left ventricular hypertrophy. However, improved criteria like total \nQRS voltage can still be adopted for the detection of LVH at a primary healthcare level.