Diagnostic utility of the electrocardiographic left ventricular hypertrophy criteria in specific populations

Fernando De la Garza Salazar, Elías Abraham Rodríguez Díaz, Arnulfo González Cantú, José Ramón Azpiri López, Mauricio Kuri Ayache, Maria Elena Romero Ibarguengoitia

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Background: Several electrocardiographic (ECG) criteria have been validated for the diagnosis of left ventricular hypertrophy (LVH); the majority in Caucasian subjects from Europe and North America. Diagnostic utility of ECG criteria to detect LVH has never been established in our population; nonetheless they are frequently used. Objective: To evaluate the diagnostic utility of different LVH ECG criteria in a Northern Mexican population and to determine the effect of gender, age, body mass index (BMI), hypertension and ischaemic heart disease (IHD) on their performance. Methods: We conducted an observational, case-control study in patients divided according to the presence of LVH in an echocardiogram (Echo). We calculated the accuracy, sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 22 ECG criteria. Results: Four hundred thirty-two patients were studied (202 had LVH). The Dalfó criterion (ECG18. SV3 + RaVL) had the best diagnostic performance with a Se of 56%, Sp of 71.3%, PPV 62.9%, NPV 65% and a diagnostic accuracy (95%CI) of 64.1% (59.5–68.6). This criterion had the highest accuracy in both genders, in all BMI, in older patients (>60 years) and in those with positive Echo ischaemic heart disease (IHD); it also performed well in patients with history of IHD and in hypertensive patients. VDP Cornell had the best accuracy in patients less than 60 years old, and in patients with non-ischaemic findings by Echo. Conclusions: The Dalfó criteria had the overall best accuracy in the detection of LVH, and specific populations.

Original languageEnglish
Number of pages8
JournalActa Cardiologica
Publication statusAccepted/In press - 1 Jan 2020


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

De la Garza Salazar, F., Rodríguez Díaz, E. A., González Cantú, A., Azpiri López, J. R., Kuri Ayache, M., & Romero Ibarguengoitia, M. E. (Accepted/In press). Diagnostic utility of the electrocardiographic left ventricular hypertrophy criteria in specific populations. Acta Cardiologica. https://doi.org/10.1080/00015385.2020.1721718