Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

Søren Sandager Petersen, Line Reinholdt Pedersen, Manan Pareek, Mette Lundgren Nielsen, Søren Zöga Diederichsen, Margrét Leósdóttir, Peter M. Nilsson, Axel Cosmus Pyndt Diederichsen, Michael Hecht Olsen

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population. Methods: We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. Results: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval (CI): 1.27-2.15), p = .0002, odds ratio: 1.17 per 10 mmHg (95% CI: 1.09-1.25), p < .0001, and odds ratio: 1.21 per 0.10 (95% CI: 1.02-1.42), p = .03). In addition, discrepancy was also seen in females and subjects receiving antihypertensive medication (odds ratio: 1.41 (95% CI: 1.04-1.89), p = .03 and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. Conclusion: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH determined by ECG and echocardiography.

Original languageEnglish
Pages (from-to)54-63
JournalBlood Pressure
Issue number1
Publication statusPublished - 2017 Jan 2

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Free keywords

  • Discrepancy
  • ECG
  • echocardiography
  • left ventricular hypertrophy
  • left ventricular mass


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