EVALUATION OF SELECTED ELECTROCARDIOGRAPHIC CRITERIA FOR DIAGNOSING LEFT VENTRICULAR HYPERTROPHY IN HYPERTENSIVES IN SOUTH-SOUTH NIGERIA

Abstract

Background: Criteria for left ventricular hypertrophy (LVH) have been almost exclusively elaborated and calibrated in white populations. Because several interethnic differences in ECG characteristics have been found, the applicability of these criteria to different races and ethnic groups needs to be demonstrated. Objective: We investigated the performance of four ECG criteria for LVH detection in Calabar, Nigeria. Methodology:12-lead ECG tracings were obtained.  Left ventricular mass was calculated with M-mode echocardiography and indexed to Height ^2.7 and body surface area as the gold standard. Results: The study population was 240 participants made up of 120 hypertensives and 120 normotensive controls. All echocardiographic parameters were significant in the hypertensives compared to the controls. On indexing for both Echo LVH HT ^2.7 and Echo LVH BSA there was no significant difference in the results. Echocardiography was more sensitive than Electrocardiography in the detection of Left Ventricular Hypertrophy in this study. Sokolow-Lyon and Cornell product criteria had the highest sensitivity (34.1%) by Echo HT ^2.7 but Cornell voltage criteria had the highest specificity (93.3%) by Echo HT ^2..7. Cornell product had the highest sensitivity by Echo BSA (34.3%) while Cornell voltage had the highest sensitivity by Echo BSA (94.7%). Conclusion: Sensitivity of existing criteria is low, performance of classic ECG criteria for LVH detection appeared to be lower in this population of African origin. Further studies are required to generate new criteria to measure performance in Africans and those of black ethnicity.