Electro- and echocardiographic features of left ventricle hypertrophy in patients with hypertrophic cardiomyopathy.

BACKGROUND

Standard 12-lead electrocardiogram (ECG), next to medical history and physical examination, is a basic screening tool for hypertrophic cardiomyopathy in General practice. There are many electrocardiographic criteria of left ventricular hypertrophy, but their accuracy is usually weak in patients with systemic hypertension or aortic stenosis. Sensitivity of these criteria in patients with HCM has not been well described.

AIM

To assess the prevalence of electrocardiographic criteria for LVH in patients with HCM and their relationship with echocardiographic parameters.

MATERIAL AND METHODS

A total of 49 patients with HCM (mean age 53.2 ± 15.4 years; men/women: 31/18) were enrolled to study. Eight electrocardiographic criteria for LVH were evaluated and correlated with echocardiographic parameters.

RESULTS

The ECG features of LVH were found in 36 (73.5%) subjects. These patients had increased thickness of intraventricular septum (20.5 ± 4.7 vs. 17.3 ± 3.2 mm, p = .03), LVM (340.5 ± 104.8 vs. 264.0 ± 61.5 g; p = .02), and LVMI (178.9 ± 48.8 vs. 125.9 ± 22.5; p = .002). All of ECG criteria for LVH had low sensitivity (14.3%-40.8%) for LVH diagnosis confirmed by echocardiography. The most common positive criterion was Cornell Voltage (20 patients; 40.8%). A total of 41 (83.4%) patients had T-wave inversion in limb and/or precordial leads. LVMI correlated positively with R-wave amplitude in aVL (R = 0.34; p = .03), Gubner-Ungerleider voltage (R = 0.4; p = .009), and Cornell Voltage (R = 0.31; p = .04).

CONCLUSION

ECG criteria for LVH are characterized by poor sensitivity in patients with HCM. Cornell Voltage and criteria based on limb leads correlate positively with LVMI.