UTILITY OF ELECTROCARDIOGRAM FOR PREDICTING INCREASED LEFT-VENTRICULAR MASS IN ASYMPTOMATIC MEN AT RISK FOR CARDIOVASCULAR-DISEASE

The objective of this study was to test the value of electrocardiogram for predicting left ventricular mass (LVM), assessed echographically in 136 asymptomatic men with at least one major cardiovascular risk fa ctor. We measured the Sokolow-Lyon and Cornell voltages, as well as th e ratio of Cornell voltage to QRS voltage in lead II. The prevalence o f left ventricular hypertrophy (LVH), defined as LVM of greater than o r equal to 125 g/m(2), was 6%, whereas that of increased LVM, defined as LVM of greater than or equal to 99 g/m(2), the 90th upper percentil e of a control group, was 29%. Receiver operating characteristics curv es showed that for predicting LVH at 80% specificity, the Cornell/QRS( II) voltage ratio had a sensitivity of 75%, whereas those of the Corne ll and Sokolow-Lyon voltages were 50% and 12.5%, respectively. For pre dicting increased LVM at 80% specificity, the Cornell/VQRS(II) voltage ratio had a sensitivity of 56%, whereas the sensitivities of the Corn ell and Sokolow-Lyon voltages were 36% and 22%, respectively. We concl ude that, in constrast with the Sokolow-Lyon voltage, the new dimensio nless Cornel/QRS(II) voltage shows a sensitivity at a high specificity value at least as acceptable as that of the Cornell voltage for predi cting borderline-high LVM in a population with a low prevalence of LVH . Am J Hypertens 1998;11:861-865 (C) 1998 American Journal of Hyperten sion, Ltd.