A comparative and correlation study of electrocardiographic and echocardiographic left ventricular parameters in hypertension

Abstract

Background: Routine echocardiographic assessment of left ventricular (LV) size and function in hypertensive individuals is desirable, but in resource-challenged African countries where this may be impracticable it is important to identify patients who after electrocardiographic (ECG) evaluation would benefit from further evaluation with echocardiography. Objective: To compare the echocardiographic parameters reflective of LV size and systolic function in hypertensive patients with normal ECG, LV hypertrophy (LVH) by voltage criteria only, and LVH with strain on electrocardiogram. Subjects and Methods: A cross-sectional comparative study of echocardiographic LV size and systolic function in hypertensive participants with normal ECG (60 participants), LVH with strain (51 participants), and LVH by voltage criteria only (50 participants) on ECG, attending the Cardiology Clinic of a University Teaching Hospital in Lagos, Nigeria. Results: ECG LVH with strain was associated with greater LVM index, higher prevalence of echocardiographic derived LVH, increased tendency toward hypertrophic LV geometric patterns, increased LV internal dimensions, LV systolic dysfunction, dilated left atrium and aortic root, as compared with ECG LVH by voltage criteria only and normal ECG in Nigerian hypertensive patients. Conclusion: ECG LVH with strain identifies a group of hypertensive individuals who are at increased cardiovascular risk and would benefit from further evaluation by echocardiography. Where echocardiography may not be readily accessible, this ECG pattern may aid decision making on appropriate therapeutic interventions.