The Accuracy of an EKG for Predicting Left Ventricular Hypertrophy: Correlation with BMI, Systolic Blood Pressure, and Heart Rate, a Retrospective Data Analysis

Abstract

Left ventricular hypertrophy (LVH) is a disease that manifests as an increase in the mass of the left ventricle, secondary to an increase in wall and/or cavity size. Hypertrophic cardiomyopathy is a genetic condition that causes LVH with prevalence as high as 1 in 500. Adult EKG criteria are insensitive but highly specific, yet pediatric criteria are neither sensitive nor specific. The purpose of this study was to determine if there is a statistical correlation between commonly used EKG voltage criteria for LVH with 2D echocardiogram measurement of LV diameter and wall thickness. We investigated the relationship between EKG voltage, specifically the R wave in V5 and S wave in V2, and how they correlate with systolic blood pressure, BMI, and heart rate. We analyzed community data from the Anthony Bates Foundation with 1351 people screened using both EKGs and echocardiograms. The study population had an average age of 28, were majority Caucasian (73%), had an average systolic blood pressure of 125 and an average BMI of 24.1. We found that there is no significant correlation between the R wave in V5 and HR (p = 0.79) or LV outflow tract diameter (p = 0.82). There was, however, a significant relationship between the R wave in V5 and septal thickness (p = 0.0002), BMI (p < 0.0001), and systolic blood pressure (p = 0.0172). There was only a significant relationship between the S wave in V2 and heart rate (p = 0.03). With these factors in mind, a better screening system may be developed that takes into account BMI and systolic blood pressure in the EKG screening for LVH.