Presenting Author:
ELECTROCARDIOGRAM IN THE ASSESSMENT OF LEFT ATRIAL ENLARGEMENT AND LEFT VENTRICULAR HYPERTROPHY: COMPARISON WITH TWO-DIMENSIONAL ECHOCARDIOGRAM AND CARDIAC MAGNETIC RESONANCE IMAGING
S. Kumar, R.S. Marfatia, M. Rai, R. Feinn, E. Kaloudis, C. Yang, E. Avelar
University of Connecticut Health Center, Farmington, CT, USA
Background: We aimed to test the accuracy of electrocardiography (ECG) compared to transthoracic echocardiogram (TTE) and cardiovascular magnetic resonance imaging (CMR).
Methods: 110 hypertensive patients underwent evaluation (mean age 75±10years, BMI 33±5kg/m2 and SBP/DBP 129±14/72±11mm Hg). ECG criteria for left atrial enlargement (LAE) included bifid P waves and P duration>110 ms in lead II. Left ventricular hypertrophy (LVH) was assessed by Sokolow-Lyon, Cornell Voltage and Framingham criteria. Left atrial volume and LV size were assessed by TTE and CMR. Pearson’s correlation among the ECG, TTE and CMR parameters were performed.
Results: P wave duration >110ms in lead II correlated significantly with both LA volume by TTE and CMR. There was a significant correlation between all 3 LVH-ECG criteria and LV mass by CMR, highest being with the Cornell criteria. LVH by TTE only correlated with Sokolow-Lyon criteria.(Table)
Conclusions: Cornell voltage criteria and P duration >110ms in lead II provided the most accurate measurements of increased left ventricular mass and left atrial volume by CMR respectively.
|LEFT VENTRICULAR HYPERTROPHY AND LEFT ATRIAL ENLARGEMENT BY ECG: COMPARISON WITH TTE AND CMR |
| |LEFT VENTRICULAR HYPERTROPHY | |
|LVH-ECG Criteria |LVH-TTE |LV Mass-CMR |
|Sokolow-Lyon |r = 0.221* |r = 0.425* |
|(SV1+RV5/RV6 ≥ 35mm) | | |
|Cornell Voltage |r = 0.186 |r = 0.509* |
|(SV3 + RaVL >24mmMALES, >20mmFEMALES) |p = 0.063 | |
|Framingham |r = 0.099 |r = 0.289* |
|(RaVL>11mm) |p = 0.324 | |
| |LEFT ATRIAL ENLARGEMENT | |
|LA enlargement- ECG lead II |LA Volume-TTE |LA Volume-CMR |
|P Wave>110 ms |r = 0.240* |r = 0.306* |
|Bifid P Wave |r = 0.001 |r = 0.083 |
| |p = 0.992 |p = 0.493 |
|*p ................
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