Diagnostic Accuracy of the Electrocardiography Criteria for Left Ventricular Hypertrophy in Comparison with Echocardiography in Hypertensives

Abstract

Background: Electrocardiography (ECG) and echocardiography (ECHO) are routinely employed to detect LVH. ECG, although widely accessible and non-invasive, demonstrates variable sensitivity and specificity. Echocardiography remains the diagnostic gold standard due to its superior capability in visualizing cardiac structure and quantifying left ventricular mass with higher accuracy.

Objective: To assess the diagnostic performance of various ECG criteria in detecting LVH among hypertensive individuals and to compare these findings with echocardiographic results, thereby determining the reliability of ECG in relation to ECHO.

Methods: A cross-sectional study was conducted at Aarupadai Veedu Medical College and Hospital between June 2022 and June 2024, involving 170 patients diagnosed with hypertension. Inclusion was limited to hypertensive patients with echocardiographically confirmed LVH, while individuals with valvular heart disease, hypertrophic obstructive cardiomyopathy, anemia, or thyrotoxicosis were excluded.

Results: The majority of participants (45.3%) were within the 51–60-year age group. Among the ECG criteria assessed, Sokolow-Lyon (35.2%) and Cornell Voltage (32.3%) were most frequently indicative of LVH. Echocardiographic analysis revealed concentric LVH in 67.1% of patients and eccentric LVH in 32.9%. ECG failed to detect several cases confirmed by ECHO, underscoring the limitations of ECG in isolation. No statistically significant associations were observed between LVH findings and other clinical variables.

Conclusion: LVH is commonly observed in hypertensive patients, especially in those aged 51–60 years, with concentric LVH being more prevalent. Although ECG serves as a useful initial screening tool, its limited sensitivity necessitates the use of echocardiography for definitive diagnosis. Integrating ECG with ECHO enhances diagnostic precision and facilitates better clinical management of hypertensive patients at risk of LVH.