Phillips RA, Rao, Butkevich A, Roychoudhury D, Blanco-Franco
O, et al
Are the sensitivity and specificity of ECG criteria for LVH so
bad?
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:46A 1997
Introduction. The diagnostic test characteristics of ECG criteria of
LVH
are thought to be inadeqaute compared to 1D echo. 2D or 3D echo is more
accurate and
reliable than the 1D method.
What was done. Various sets of ECG criteria were compared relative to
LV
mass by 1D, 2D and 3D echo in 20 subjects. The sensitivity of ECG scores
for detection of LVH was better when echo-LVH was determined by 3D, as
opposed to 2D or 1D echocardiography.
Comment: A large body of evidence suggests that LV hypertrophy is
worth detecting because it worsens prognosis and because it is
reversible. ECG is not sensitive enough and much too non-specific. Even
with the most optimistic comparisons, if the the prevalence of LVH is
20%, this approach would produce about 3 times as many false positives
as true positives.
(Robert Foley, M.D., (University of Newfoundland, St. John's,
Canada)
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12th Annual ASH Meeting
H: Exam and lab tests :
Tests for LVH
H: Pathophysiology :
Heart in hypertension