Consistency of left ventricular hypertrophy diagnosed by electrocardiography and echocardiography: the Northern Shanghai Study

Figures & data

Table 1 Characteristics of participants by gender

Characteristics	Overall (n=1,758)	Men (n=784)	Women (n=974)	P-value
Age, years	71.4±6.1	71.4±6.0	71.4±6.1	0.88
Body height, cm	160.0±8.3	166.4±6.1	154.8±5.7	<0.001
Body weight, kg	62.5±10.6	67.6±10.0	58.3±9.1	<0.001
BMI, kg/m^2	23.9±3.5	23.9±3.2	23.9±3.6	0.81
BSA, m^2	1.66±0.17	1.76±0.15	1.58±0.14	<0.001
SBP, mmHg	134.5±17.7	134.6±16.7	134.4±18.4	0.80
DBP, mm Hg	78.90±9.2	79.9±9.3	78.1±9.0	<0.001
Diabetes, n (%)	336 (19.1)	146 (18.6)	190 (19.5)	0.65
Hypertension, n (%)	921 (52.4)	421 (53.8)	500 (51.3)	0.31
ECG parameters and indices
RaVL, mV	0.42±0.29	0.41±0.30	0.43±0.28	0.14
SV3, mV	0.72±0.44	0.82±0.46	0.65±0.42	<0.001
QRS duration, ms	91.23±14.61	95.90±15.35	87.47±12.81	<0.001
SL index, mV	2.44±0.80	2.61±0.85	2.31±0.73	<0.001
Cornell criterion, mV	1.15±0.55	1.23±0.57	1.08±0.53	<0.001
CP criterion, mV/ms	134.7±60.3	118.8±64.7	147.5±53.1	<0.001
ECHO parameters and indices
IVS, mm	9.47±1.87	9.61±1.94	9.38±1.81	0.011
PWT, mm	9.10±1.56	9.27±1.57	8.96±1.54	<0.0001
LVID, mm	46.71±6.80	47.90±7.05	45.75±6.43	<0.0001
LVM, g	151.1±53.1	161.0±57.1	143.1±48.1	<0.0001
LVM/BSA, g/m^2	90.5±28.9	90.8±29.7	90.3±28.3	0.74
LVM/height^2.7, g/m^2.7	42.7±15.1	40.8±14.3	44.2±15.5	<0.0001

Notes: Data means ± SD or numbers with percentages in parenthesis. Student’s t-test and chi-squared analysis were conducted for the comparison of continuous and dichotomized variables between men and women.

Abbreviations: BMI, body mass index; BSA, body surface area; CP, Cornell Product; ECG, electrocardiography; ECHO, echocardiography; height^2.7, LVM indexed for 2.7 power of body height; IVS, interventricular septum; LVID, left ventricular internal diameter; LVM, left ventricular mass; LVMI/BSA, LVM indexed for BSA; LVMI/PWT, LVM indexed for posterior wall thickness; PWT, posterior wall thickness; RaVL, R wave of lead aVL; SL, Sokolow-Lyon; SV3, S wave of the leads V3.

Table 2 Characteristics of participants by hypertensive status

Characteristics	Overall (n=1,757)	Hypertension (n=921)	No hypertension (n=836)	P-value
Age, years	71.4±6.1	72.0±6.2	70.8±5.8	<0.001
ECG parameters and indices
RaVL, mV	0.42±0.29	0.46±0.30	0.38±0.26	<0.001
SV3, mV	0.72±0.44	0.77±0.47	0.68±0.42	<0.001
QRS duration, ms	91.22±14.61	91.88±15.26	90.48±13.82	0.044
SL index, mV	2.44±0.80	2.54±0.84	2.33±0.74	<0.001
Cornell criterion, mV	1.15±0.55	1.23±0.58	1.06±0.51	<0.001
CP criterion, mV/ms	134.7±60.3	143.0±65.2	125.5±52.8	<0.001
ECHO parameters and indices
IVS, mm	9.49±1.87	9.79±1.96	9.15±1.71	<0.001
PWT, mm	9.10±1.56	9.30±1.62	8.88±1.46	<0.001
LVID, mm	46.70±6.79	47.73±6.88	45.57±6.52	<0.001
LVM, g	151.0±53.0	161.8±55.6	139.1±47.2	<0.001
LVM/BSA, g/m^2	90.5±28.9	95.7±29.8	84.7±26.7	<0.001
LVM/height^2.7, g/m^2.7	42.7±15.1	45.7±15.3	39.3±14.1	<0.001

Abbreviations: BSA, body surface area; CP, Cornell Product; ECG, electrocardiography; ECHO, echocardiography; IVS, interventricular septum; LVID, left ventricular internal diameter; height^2.7, LVM indexed for 2.7 power of body height; LVM, left ventricular mass; PWT, posterior wall thickness; RaVL, R wave of lead aVL; SL, Sokolow-Lyon; SV3, S wave of the leads V3.

Table 3 Correlation coefficient (R) between the electrocardiographic and echocardiographic parameters for the detection of LVHin total participants, in both males and females

Index	SL (SV1 + RV5)		Cornell (SV3 + RaVL)		CP (SV3 + RaVL) × QRS duration
	R	P-value	R	P-value	R	P-value
LVM/BSA
Total	0.15	<0.001	0.16	<0.001	0.18	<0.001
Male	0.23	<0.001	0.17	<0.001	0.21	<0.001
Female	0.09	<0.01	0.15	<0.001	0.16	<0.001
LVM/height^2.7
Total	0.09	<0.001	0.15	<0.001	0.21	<0.001
Male	0.20	<0.001	0.17	<0.001	0.21	<0.001
Female	0.05	0.091	0.17	<0.001	0.17	<0.001

Note: Pearson’s correlation analysis was applied between the electrocardiographic and echocardiographic parameters for the detection of LVH in total participants, in both males and females.

Abbreviations: BSA, body surface area; CP, Cornell Product; LVM, left ventricular mass; RaVL, R wave of lead aVL; RV5, R wave of lead V5; SL, Sokolow-Lyon; SV1, S wave of the leads V1; SV3, S wave of the leads V3.

Table 4 Chi-squared test between LVH diagnosed by ECG and by ECHO

Index	LVH1: LVM/BSA M ≥125 g/m^2, F ≥110 g/m^2		LVH2: LVM/BSA M ≥115 g/m^2, F ≥95 g/m^2		LVH3: LVM/height^2.7 M ≥51 g/m^2.7, F ≥47 g/m^2.7
	χ^2	P-value	χ^2	P-value	χ^2	P-value
LVH diagnosed by ECHO
SL-China (M ≥4.0 mV, F ≥3.5 mV)	24.15	<0.001	16.00	<0.001	15.99	<0.001
SL (M/F ≥3.5 mV)	14.34	<0.001	7.52	<0.01	9.67	<0.01
Cornell (M ≥2.8 mV, F ≥2.0 mV)	5.92	0.02	4.30	0.04	5.51	0.02
CP (M/F ≥244 mV/ms)	2.71	0.10	5.10	0.02	9.23	<0.01

Abbreviations: BSA, body surface area; CP, Cornell Product; ECG, electrocardiography; ECHO, echocardiography; F, female; LVH, left ventricular hypertrophy; LVM, left ventricular mass; LVH1, LVH diagnosed by LVM indexed for BSA (LVMI ≥125 g/m² in males and ≥110 g/m² in females); LVH2, LVH diagnosed by LVM indexed for BSA (LVMI ≥115 g/m² in males and ≥95 g/m² in females); LVH3, LVH diagnosed by LVM indexed for body height^2.7 (LVMI2 ≥51 g/m^2.7 in males and ≥47 g/m^2.7 in females); M, male; SL, Sokolow-Lyon.

Figure 1 ROC curve with three electrocardiographic criteria for detecting LVH1, LVH2, and LVH3, the ROC curve for defining LVH1 using LVM indexed for BSA (LVMI) ≥125 g/m² in males and ≥110 g/m² in females; the ROC curve for defining LVH2 using LVM indexed for BSA (LVMI) ≥115 g/m² in males and ≥95 g/m² in females; the ROC curve for defining LVH3 using LVM indexed for BSA (LVMI2) ≥51 g/m^2.7 in males and ≥47 g/m^2.7 in females. N indicates P>0.05 and **indicates P<0.01.

Abbreviations: AUC, area under curve; BSA, body surface area; CP, Cornell Product; LVH, left ventricular hypertrophy; LVM, left ventricular mass; ROC, receiver operating characteristic; SL, Sokolow-Lyon.