Premium
Relationship between Echocardiographic LV Mass and ECG Based Left Ventricular Voltages in an Adolescent Population: Related or Random?
Author(s) -
CZOSEK RICHARD J.,
CNOTA JAMES F.,
KNILANS TIMOTHY K.,
PRATT JESSE,
GUERRIER KARINE,
ANDERSON JEFFREY B.
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12416
Subject(s) - medicine , cardiology , population , environmental health
Background In attempts to detect diseases that may place adolescents at risk for sudden death, some have advocated for population‐based screening. Controversy exists over electrocardiography (ECG) screening due to the lack of specificity, cost, and detrimental effects of false positive or extraneous outcomes. Objectives Analyze the relationship between precordial lead voltage on ECG and left ventricle (LV) mass by echocardiogram in adolescent athletes. Methods Retrospective cohort analysis of a prospectively obtained population of self‐identified adolescent athletes during sports screening with ECG and echocardiogram. Correlation between ECG LV voltages (R wave in V 6 [RV6] and S wave in lead V 1 [SV1]) was compared to echocardiogram‐based measurements of left ventricular mass. Potential effects on ECG voltages by body anthropometrics, including weight, body mass index (BMI), and body surface area were analyzed, and ECG voltages indexed to BMI were compared to LV mass indices to analyze for improved correlation. Results A total of 659 adolescents enrolled in this study (64% male). The mean age was 15.4 years (14–18). The correlations between LV mass and RV6, SV1, and RV6 + SV1 were all less than 0.20. The false positive rate for abnormal voltages was relatively high (5.5%) but improved if abnormal voltages in both RV6 and SV1 were mandated simultaneously (0%). Indexing ECG voltages to BMI significantly improved correlation to LV mass, though false positive findings were increased (12.9%). Conclusion There is poor correlation between ECG precordial voltages and echocardiographic LV mass. This relationship is modified by BMI. This finding may contribute to the poor ECG screening characteristics.