Left ventricular mass by 12-lead electrocardiogram in healthy subjects: comparison to cardiac magnetic resonance imaging

Abstract

The ability to estimate left ventricular mass (LVM) from the standard 12-lead electrocardiogram (ECG) has been shown to be limited because there is a considerable variability of the normal 12-lead ECG due to demographic and anthropometric variables. We sought to study LVM in healthy subjects and its relationship with QRS duration, and established electrocardiographic criteria for left ventricular hypertrophy. Cardiac magnetic resonance imaging was used to measure LVM. Seventy-one healthy volunteers (36 men; age range, 21-82 years) were studied. All ECG criteria tested showed a statistically significant relationship with LVM. The highest R value was found between LVM and QRS duration, as well as the 12-lead voltage-duration product (R = 0.59, P < .001 for both). The lowest R value was found for the Sokolow-Lyon voltage criterion (R = 0.25, P = .033). Left ventricular mass differed significantly between sexes, as did all ECG criteria except the Sokolow-Lyon criterion. Thus, in healthy subjects, QRS duration alone is equally or more strongly correlated to LVM than are established electrocardiographic left ventricular hypertrophy criteria.

Electrocardiographic left ventricular hypertrophy has low diagnostic accuracy in middle‐aged subjects

“…While the AUCs for Sokolow-Lyon and Sokolow-Lyon product were 0.72 in hypertensive patients, these estimates had wide confidence intervals and should be interpreted with caution. Although SokolowLyon and Cornell voltage criteria have also been shown to correlate with left ventricular mass in healthy subjects (26), our data suggests that they have no discrimination ability in normotensive subjects. Furthermore, a screening test performed on asymptomatic subjects should have high specificity.…”

“…In normal-weight subjects, LVMI correlated with Sokolow-Lyon voltage (r50. 26 (23,24). However, these criteria seem far too complicated for clinical use.…”

Ventricular activation is impaired in aged rat hearts

“…The expected increase in conduction velocity due to larger myocyte transverse diameter (48) is likely counteracted by a reduction in myocardial Cx43 expression. In addition, the increase in heart mass, which might also prolong QRS duration, should have a moderate effect (9). A significant reduction in T (Ϫ19%) was previously reported in the RV of aged hearts by Stein et al (43).…”

Relationship between Urinary Albumin Excretion and Left Ventricular Mass with Mortality in Patients with Type 2 Diabetes

“…The prognostic value of electrocardiographic criteria to measure LVM has been shown in recent studies (22,23). Another study also demonstrated in healthy subjects that 12-lead ECG with Cornell voltage is strongly correlated with measured LVM by magnetic resonance imaging (24).…”