Time-voltage QRS area of the 12-lead electrocardiogram: detection of left ventricular hypertrophy

Hypertension
P M OkinP Kligfield

Abstract

Identification of left ventricular hypertrophy (LVH) using 12-lead ECG criteria based primarily on QRS amplitudes has been limited by poor sensitivity at acceptable levels of specificity. Because the product of QRS voltage and duration, as an approximation of the time-voltage area of the QRS complex, can improve accuracy of the 12-lead ECG for LVH, we examined the diagnostic value of true time-voltage area measurements of QRS complexes from the standard 12-lead ECG. Standard 12-lead ECGs and echocardiograms were obtained in 175 control subjects without LVH and in 74 patients with regurgitant valvular heart disease and LVH defined by echocardiographic criteria (indexed LV mass >110 g/m2 in women and >125 g/m2 in men). Standard voltage criteria, voltage-duration products (voltage multiplied by QRS duration), and true time-voltage areas of the QRS were calculated for Sokolow-Lyon criteria (SV1 +RV(5/6)) and the 12-lead sum of voltage criteria. Test sensitivities were compared using gender-specific partitions with matched specificity of 98% in the 175 subjects without LVH. Measurement of the time-voltage area significantly improved sensitivity for both criteria. The 76% sensitivity of the 12-lead sum area and 65% sensitivity of Sok...Continue Reading

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Citations

Dec 7, 2013·International Urology and Nephrology·Rizna Abdul CaderRozita Mohd
Apr 26, 2008·Pediatric Cardiology·Peter R RijnbeekJan A Kors
Feb 26, 2014·Cell Biochemistry and Biophysics·Changzhao Gao, Dandan Yang
Mar 24, 2012·Journal of Hypertension·Philippe GosseSunthareth Yeim
Nov 16, 2012·Journal of Hypertension·Fabio AngeliPaolo Verdecchia
May 28, 2010·Clinical and Experimental Hypertension : CHE·Alberto CalderónJosefa Navarro-Cid
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Sep 19, 2009·Pacing and Clinical Electrophysiology : PACE·Yueh-Juh LinChing-Chi Chu
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