ECG voltage criteria for the diagnosis of inappropriateness of left ventricular mass in Korean patients.

Abstract

Background and Objectives: Inappropriateness of left ventricular mass is a useful index in predicting the function of left ventricle(LV) or the risk of cardiovascular diseases. The normal values of LV mass were relatively similar between genders in Korean population. But the relationship between ECG voltage criteria and the appropriateness of LV mass was not studied yet. Materials and methods: 334(161 male, 173 female) patients were analyzed for their ECG and the echocardiogram. Sokolow-Lyon(SL) and Cornell voltage(CV) criteria and Cornell product(CP) was used. Diagnostic value was assessed by referring to the echocardiographic LVH, > 54 or 53 g/height2.7 in male and female, respectively. Inappropriateness of LV mass was defined when O/P ratio was >132%. And sensitivities were derived at the specificity level of 95%. Results: In the assessment of the inappropriateness of LV mass, The sensitivities were 10.4%, 20.9%, 16.4% for SL voltage(35mm), CV(20mm), CP(2114 uV·msec), respectively. In male, the sensitivities were 10.8%, 13.5%, 10.8% for SL voltage(36.2mm), CV(21.4mm), CP(2430 uV·msec), respectively. In female, the sensitivities were 20%, 20%, 23,3% for SL voltage(32.4mm), CV(19.1mm), CP(1821 uV·msec), respectively. For LVH in male, sensitivities were 12.3%, 21.5%, 18.5 % for SL voltage(34.3mm), CV(19.8mm), CP(2131 uV·msec), respectively. When CV criteria of 28mm be applied to male patients, the sensitivity/specificity was 2.7%/100% , 1.5%/100% for inappropriate LV mass and LV hypertrophy, respectively. Conclusion: In general, ECG criteria for inappropriate LV mass are similar to LVH criteria. And the cut-off values are similar to that used in western country but in male patients, Cornell voltage cut-off value used in western country is too high for Korean patients. Cornell voltage of 21.4mm is better criterion for Korean male patients.