Sensitivity and specificity of electrocardiographic Left Ventricular Hypertrophy (LVH) criteria amongst hypertensives in University of Abuja Teaching Hospital, Gwagwalada, Abuja

Background: Hypertension remains one of the important risk factors for cardiovascular diseases and a major global public health problem. Left ventricular hypertrophy is a recognised complication of systemic hypertension and strongly predicts cardiovascular morbidity and mortality. In Nigeria, few studies have tested the sensitivity and specificity of multiple electrocardiographic (ECG) criteria in the diagnosis of left ventricular hypertrophy (LVH) amongst hypertensives although it is a commonly used diagnostic method. This study sets out to determine the sensitivity and specificity various ECG criteria of LVH amongst patients with hypertension. Methodology: One hundred and seventy-eight hypertensives were recruited consecutively into the study. They all had ECG done using standard methodology. They all had echocardiography done to assess the presence of echocardiographic LVH. ECG-LVH was determined using various ECG criteria. Results: The various ECG criteria for the diagnosis of LVH were lower in sensitivities (23.5%–38.6%) compared to specificities (64.1%–72.9%). The Cornell voltage (CV) criterion had the combination of the highest sensitivity and specificity at 38.6% and 72.9%, respectively. The Massoleini criterion (MC) had similar values with CV criteria with sensitivity of 38.6% and specificity of 72.9%. The Romhilt criterion had a high specificity of 64.1% but low in sensitivity (23.5%). The sensitivity and specificity obtained for Sokolow–Lyon (SL) criterion were 28.9% and 64.0%, respectively. The corresponding values for Cornell product criterion were 34.6% and 69.4%, whereas those of Goldberger criterion were 34.4% and 68.0%. The prevalence of echocardiographic LVH was 32.4%. Conclusion: CV, SL and MC ECG criteria had the best combination of sensitivities and specificities and therefore are good testing criteria for LVH in patients with hypertension.