Mo758diagnostic Accuracy of Electrocardiographic Methods of Estimation of Left Ventricular Hypertrophy in a Haemodialysis Population

Abstract

Background and Aims Left ventricular hypertrophy is common in end stage renal disease (ESRD) and haemodialysis. Its association with cardiovascular outcomes has been demonstrated. In this study we evaluated the diagnostic accuracy of electrocardiographic methods of calculating LVH compared to Real Time 3- Dimensional Echocardiogram (RT3DE) which we used as a surrogate gold standard test. Method This study was performed as a post-hoc analysis of a sub-group of patients enrolled into the Salford Kidney Study (SKS). Patients included into this analysis are from the sub-group of SKS previously known as the CRISIS-HD cohort. All adult haemodialysis patients at Salford Royal NHS Foundation Trust, UK or one of its satellite units are considered for inclusion. In this study we examined the sensitivity, specificity, positive predictive value and negative predictive value of Sokolow – Lyon and Romhilt –Estes methods in comparison to RT3DE. Results The final sample comprised 44 patients. The vast majority were Caucasian (39 patients). The mean age of the patients was 62 ± 13 years and mean time on dialysis 5.1 ± 2.9 years. The sensitivity of both ECG methods for diagnosis of LVH was very low. This was the case for the whole sample and also for individual groups. Romhilt – Estes was marginally better than Sokolow – Lyon and that was especially the case for male patients. Conclusion Our study shows that ECG methods for assessment of LVH that rely on voltage criteria have very low sensitivity and unreliable specificity compared to RT3DE and also conventional M –Mode echocardiography. As a result, they could not be reliably used as a quick and inexpensive method of LVH estimation in clinical practice in the case of haemodialysis patients.