Comparación de la sensibilidad y especificidad de los criterios electrocardiográficos para la hipertrofia ventricular izquierda según métodos de Romhilt-Estes, Sokolow-Lyon, Cornell y Rodríguez Padial

Abstract

Debido a que la masa ventricular izquierda está asociada con un aumento en el riesgo de morbilidad y mortalidad de las enfermedades cardiovasculares en la población general y siendo el electrocardiograma un método accesible y económico para el diagnóstico de la hipertrofia ventricular izquierda, decidimos calcular la sensibilidad y la especificidad de 5 criterios electrocardiográficos para el diagnóstico de la hipertrofia ventricular izquierda y comparar los resultados de nuestro estudio con los de los autores originales.

Introduction and objectives: Because left ventricular mass is associated with an increase in the risk of morbidity and mortality of cardiovascular diseases in the general population having the electrocardiogram as an accessible and inexpensive method for the diagnosis of left ventricular hypertrophy, we decided to calculate the sensitivity and specificity of 5 electrocardiographic criteria for the diagnosis of left ventricular hypertrophy and to compare the results of the original authors to ours.

Patients and methods: 135 patients were evaluated; 46 patients were excluded by the following criteria: chronic obstructive pulmonary disease, complete left or right bundle branch block, cardiovascular ischemic disease or Wolf-Parkinson-White Syndrome. 89 patients remained and had an electrocardiogram performed applying the following criteria: Romhilt-Estes Point-Score system. Sokolow-Lyon (SV1 + RV5 or V6 > 3.5 mV) and (RaVL > 1.1 mV), Cornell and Rodríguez Padial. Left ventricular hypertrophy was defined by the Penn Convention Criteria.

Results: In our study we obtained the following results: a) Romhilt-Estes had a sensitivity of 12% and a specificity of 87%; b) Sokolow-Lyon (SV1 + RV5 or V6) had a sensitivity of 22% and a specificity of 79%; c) Sokolow-Lyon (RaVL) has a sensitivity of 18% and a specificity of 92%; d) Cornel had a sensitivity of 31% and a specificity of 87%, and e) Rodríguez Padial had a sensitivity of 82% and a specificity of 8%. There are similarities between our results and the authors's original ones. However, there are significant statistical differences between them (p < or = 0.01).

Conclusion: Our conclusion is that these criteria have a low diagnostic value in the isolated interpretation of patients with left ventricular hypertrophy, and we need to integrate them with the whole medical history and physical examination.