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


METHODS
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.


RESULTS
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), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography.


CONCLUSION
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.
['Petersen|Søren Sandager|SS|', 'Pedersen|Line Reinholdt|LR|', 'Pareek|Manan|M|', 'Nielsen|Mette Lundgren|ML|', 'Diederichsen|Søren Zöga|SZ|', 'Leósdóttir|Margrét|M|', 'Nilsson|Peter M|PM|', 'Diederichsen|Axel Cosmus Pyndt|AC|', 'Olsen|Michael Hecht|MH|']
D000368:Aged D001786:Blood Glucose D001794:Blood Pressure D004452:Echocardiography D004562:Electrocardiography D005260:Female D006801:Humans D017379:Hypertrophy, Left Ventricular D008297:Male D008875:Middle Aged
Discrepancy left ventricular hypertrophy echocardiography ECG left ventricular mass