Electrocardiography is a poor screening test to detect left ventricular hypertrophy in children

Archives of Disease in Childhood
Lucy KillianManish D Sinha

Abstract

Detection of left ventricular hypertrophy (LVH) is clinically important because it can be predictive of adverse clinical outcome. However, the best method for detecting LVH in clinical practice is unclear. The aim of this study was to evaluate electrocardiography (ECG) compared with echocardiography (ECHO) as a screening test to detect LVH in a high risk population. In a prospective, double-blinded, single centre analysis of a population of children with chronic kidney disease, LVH detected using standard 12-lead ECG (ECG-LVH) was compared with that detected with 2D-guided M-mode ECHO (ECHO-LVH). Two electrocardiographic methods (A and B) were used to diagnose ECG-LVH and compared with three different indexation methods to define ECHO-LVH. 70 consecutively enrolled participants had 107 ECG and ECHO studies performed on the same day. The prevalence of ECHO-LVH ranged from 17% to 55% using different indexation methods. Increased R wave amplitude using recent age and gender specific voltage criteria (ECG method B) demonstrated the highest sensitivity (68-76%) and specificity (43-77%) for detecting ECHO-LVH. The negative predictive value (NPV) for R waves using ECG method B was 52.4% (range 40-68.6%). For all other ECG criteria, se...Continue Reading

Citations

Feb 12, 2014·The American Journal of Cardiology·Matthew B BrothersWilliam T Mahle
May 3, 2014·Pacing and Clinical Electrophysiology : PACE·Richard J CzosekJeffrey B Anderson
Oct 28, 2019·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Denise MarconCristiano Fava
Nov 17, 2020·Frontiers in Pediatrics·Rupesh RainaDavid Kaelber

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