The strain pattern, and not Sokolow–Lyon electrocardiographic voltage criteria, is independently associated with anatomic left ventricular hypertrophy
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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.
KeywordsElectrocardiography 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.
- 2.Okin PM, Devereux RB, Nieminen MS, Jern S, Oikarinen L, Viitasalo M, Toivonen L, Kjeldsen SE, Julius S, Dahlöf B (2001) Relationship of the electrocardiographic strain pattern to left ventricular structure and function in hypertensive patients: the LIFE study. Losartan Intervention For End point. J Am Coll Cardiol 38:514–520PubMedCrossRefGoogle Scholar
- 7.Okuyama T, Ehara S, Shirai N, Sugioka K, Ogawa K, Oe H, Kitamura H, Itoh T, Otani K, Matsuoka T, Inoue Y, Ueda M, Hozumi T, Yoshiyama M (2008) Usefulness of three-dimensional automated quantification of left ventricular mass, volume, and function by 64-slice computed tomography. J Cardiol 52:276–284PubMedCrossRefGoogle Scholar
- 10.Ehara S, Matsumoto K, Shirai N, Nakanishi K, Otsuka K, Iguchi T, Hasegawa T, Nakata S, Yoshikawa J, Yoshiyama M (2013) Typical coronary appearance of dilated cardiomyopathy versus left ventricular concentric hypertrophy: coronary volumes measured by multislice computed tomography. Heart Vessels 28:188–198PubMedCrossRefGoogle Scholar
- 11.Suenari K, Nakano Y, Hirai Y, Ogi H, Oda N, Makita Y, Ueda S, Kajihara K, Tokuyama T, Motoda C, Fujiwara M, Chayama K, Kihara Y (2013) Left atrial thickness under the catheter ablation lines in patients with paroxysmal atrial fibrillation: insights from 64-slice multidetector computed tomography. Heart Vessels 28:360–368PubMedCrossRefGoogle Scholar
- 12.Ehara S, Okuyama T, Shirai N, Oe H, Matsumura Y, Sugioka K, Itoh T, Otani K, Hozumi T, Yoshiyama M, Yoshikawa J (2010) Comprehensive evaluation of the apex beat using 64-slice computed tomography: impact of left ventricular mass and distance to chest wall. J Cardiol 55:256–265PubMedCrossRefGoogle Scholar
- 13.Ehara S, Shirai N, Matsumoto K, Okuyama T, Matsumura Y, Yoshikawa J, Yoshiyama M (2011) The clinical value of apex beat and electrocardiography for the detection of left ventricular hypertrophy from the standpoint of the distance factors from the heart to the chest wall: a multislice CT study. Hypertens Res 34:1004–1010PubMedCrossRefPubMedCentralGoogle Scholar
- 14.Okin PM, Oikarinen L, Viitasalo M, Toivonen L, Kjeldsen SE, Nieminen MS, Edelman JM, Dahlöf B, Devereux RB, LIFE Study Investigators (2011) Serial assessment of the electrocardiographic strain pattern for prediction of new-onset heart failure during antihypertensive treatment: the LIFE study. Eur J Heart Fail 13:384–391PubMedCrossRefGoogle Scholar
- 19.Truong QA, Ptaszek LM, Charipar EM, Taylor C, Fontes JD, Kriegel M, Irlbeck T, Toepker M, Schlett CL, Bamberg F, Blankstein R, Brady TJ, Nagurney JT, Hoffmann U (2010) Performance of electrocardiographic criteria for left ventricular hypertrophy as compared with cardiac computed tomography: from the Rule Out Myocardial Infarction Using Computer Assisted Tomography trial. J Hypertens 28:1959–1967PubMedCrossRefPubMedCentralGoogle Scholar