Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

Abstract

<p><b>Objective:</b> To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population.</p> <p><b>Methods:</b> We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography.</p> <p><b>Results:</b> Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), <i>p</i> = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), <i>p</i> < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), <i>p</i> = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), <i>p</i> = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), <i>p</i> = .02), but FPG did not independently influence discrepancy between ECG and echocardiography.</p> <p><b>Conclusion:</b> Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.</p