Premium
Correlation between Global Longitudinal Strain and QRS Voltage on Electrocardiogram in Patients with Left Ventricular Hypertrophy
Author(s) -
Beladan Carmen C.,
Popescu Bogdan A.,
Calin Andreea,
Rosca Monica,
Matei Florin,
Gurzun MariaMagdalena,
Popara Anca V.,
Curea Fabiana,
Ginghina Carmen
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12362
Subject(s) - cardiology , medicine , qrs complex , correlation , left ventricular hypertrophy , strain (injury) , electrocardiography , muscle hypertrophy , mathematics , blood pressure , geometry
Purpose Left ventricular hypertrophy ( LVH ) is as an independent risk factor. Discrepancies were reported between LV mass ( LVM ) estimated by echocardiography and electrocardiography ( ECG ) findings. We hypothesized that QRS voltage criteria may reflect not only anatomical changes ( LVM ) but also changes in LV function and we tested the relationship between QRS voltage and echocardiographic parameters of LV function in patients (pts) with different types of LVH . Methods We prospectively enrolled pts with LVH and preserved ejection fraction ( LVEF >50%): 20 pts with isolated arterial hypertension, HTN , 20 pts with severe aortic stenosis, AS (indexed aortic valve area <0.6 cm 2 /m 2 ), and 20 pts with symmetric hypertrophic cardiomyopathy, HCM . Standard 12‐lead ECG (including Sokolow and Cornell voltage indices) and a comprehensive two‐dimensional (2D) echocardiography were performed in all. Left ventricular mass was calculated according to Devereux formula. Global longitudinal strain ( GLS ) was assessed by speckle tracking echocardiography. Results A significant correlation was found between both ECG indices and LVM assessed by echocardiography. Moreover, significant correlations were found between Sokolow–Lyon voltage and LVEF (r = 0.26; P = 0.03), GLS (r = 0.59; P < 0.001) and E/e' average (r = 0.43; P < 0.001). Cornell voltage index correlated significantly only with GLS . In multivariable analysis GLS emerged as the only independent correlate of both Sokolow–Lyon (ß = 0.6, P < 0.001) and Cornell voltage indices (ß = 0.45, P < 0.001). Conclusion These findings suggest that in pts with LVH , ECG should no longer be used only as a surrogate method for LVM estimation (structural changes only), but rather as an investigation complementary to imaging, incorporating information on overall LV remodeling (changes in structure and function).