LEFT-VENTRICULAR HYPERTROPHY IN THE ELDERLY - UNRELIABILITY OF ECG CRITERIA IN 477 SUBJECTS AGED 65 YEARS OR MORE - THE CARDIOVASCULAR STUDY IN THE ELDERLY (CASTEL)

Aim: To evaluate the diagnostic reliability of the ECG diagnosis of le ft-ventricular hypertrophy (LVH) in a cohort of elderly subjects taken from a general population. Patients: The 447 subjects with perfect ec hocardiography and ECG results of the 2,254 included in the Cardiovasc ular Study in the Elderly. Methods: Sensitivity, specificity, positive and negative predictive value of the most commonly used ECG tests of LVH were calculated versus the gold standard, echocardiography. Result s: All ECG tests had a very low sensitivity. Furthermore, except for t he Cornell index and (at least in the normotensives) the Minnesota cod e, they were not able to demonstrate the higher prevalence of LVH in e lderly females in comparison to males. The predictive value of ECG was constantly higher in males than females when negative; when positive, some tests were more predictive in males, some in females, and in oth ers, equally predictive in both sexes. Conclusions: ECG is not a relia ble method for screening LVH in elderly populations. Echocardiography and ECG give different information, and their reliability may be diffe rent if positive or negative.