Detection of best ECG criteria for diagnosis of left ventricular hypertrophy in hypertensive Egyptian patients

Background The gold standard for left ventricular hypertrophy (LVH) examination at the moment is cardiac magnetic resonance imaging, or MRI. However, due to financial concerns, two-dimensional echocardiography remains the primary standard method for estimating left ventricular mass in clinical practice. In clinical practice, ECG is now the most cost-effective way to screen for LVH, and considerable efforts have been made over the years to improve the ECG- LVH criteria’s efficacy. Aim To determine the best ECG criteria for the diagnosis of LVH in hypertensive Egyptian patients. Patients and methods This prospective study involved 200 hypertensive patients who presented to the cardiovascular department at Tanta University Hospital for echocardiographic assessment using our Philips Affinity 30 echocardiography. The study sample underwent the following: history taking, clinical examination, blood pressure assessment according to the latest ESC guidelines, a 12-lead ECG was performed, and echocardiographic evaluation: measurement was taken for LV dimension and function, LV mass was calculated and indexed for body surface area and relative wall thickness. Results Peguero–Lo Presti showed the best sensitivity to detect LVH in hypertensive Egyptian patients, while Sokolow–Lyon showed the best specificity of the three criteria. Conclusions Our study confirms the importance of applying several ECG criteria for better screening of LVH in hypertensive patients when feasible, every hypertensive patient should have an echocardiographic examination indexed to body surface area to confirm the presence or absence of LVH.