Heart and Vessels

, Volume 29, Issue 5, pp 638–644 | Cite as

The strain pattern, and not Sokolow–Lyon electrocardiographic voltage criteria, is independently associated with anatomic left ventricular hypertrophy

  • Shoichi EharaEmail author
  • Takao Hasegawa
  • Kenji Matsumoto
  • Kenichiro Otsuka
  • Takanori Yamazaki
  • Tomokazu Iguchi
  • Yasukatsu Izumi
  • Kenei Shimada
  • Minoru Yoshiyama
Original Article


Although obesity and chest-wall thickness influence the Sokolow–Lyon electrocardiographic (ECG) voltage criteria and strain pattern, these factors have not been taken into account in previous studies that evaluate the relationship between the ECG criteria and anatomic left ventricular hypertrophy (LVH). The introduction of multislice computed tomography (MSCT) has enabled assessment of not only coronary artery stenoses but also left ventricular volume and mass, left atrial volume, and chest-wall thickness. We hypothesized that evaluating the relation between the ECG voltage criteria or strain pattern and the aforementioned factors using MSCT would be highly valuable. The study population consisted of 93 patients who required MSCT angiography. The Sokolow–Lyon voltage and strain patterns were determined to detect anatomic LVH, which was defined as increased left ventricular mass. The Sokolow–Lyon voltage criteria, as an indicator of anatomic LVH, had a sensitivity of 57 %, specificity of 67 %, positive predictive value of 36 %, and negative predictive value of 82 %. By contrast, the strain pattern had a sensitivity of 65 %, specificity of 87 %, positive predictive value of 63 %, and negative predictive value of 88 %. Multivariate analysis revealed that the strain pattern was associated with the presence of anatomic LVH, whereas the Sokolow–Lyon voltage was not. This MSCT study demonstrated that even after removing the effects of various factors, the strain pattern remained associated with the presence of anatomic LVH, in contrast to the Sokolow–Lyon voltage.


Electrocardiography Sokolow–Lyon Strain Computed tomography Hypertrophy 


Conflict of interest

The authors declare that there are no financial or other relationships that could lead to a conflict of interest.


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Shoichi Ehara
    • 1
    Email author
  • Takao Hasegawa
    • 1
  • Kenji Matsumoto
    • 1
  • Kenichiro Otsuka
    • 1
  • Takanori Yamazaki
    • 1
  • Tomokazu Iguchi
    • 1
  • Yasukatsu Izumi
    • 2
  • Kenei Shimada
    • 1
  • Minoru Yoshiyama
    • 1
  1. 1.Department of Cardiovascular MedicineOsaka City University Graduate School of MedicineOsakaJapan
  2. 2.Department of PharmacologyOsaka City University Graduate School of MedicineOsakaJapan

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