Newly proposed electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in a Chinese population

Background: The electrocardiographic criteria currently available for the diagnosis of left ventricular hypertrophy (LVH) are low in sensitivity. Thus, we compared the diagnostic performance of newly proposed electrocardiographic criteria to the existing criteria in a Chinese population. Methods: A total of 235 consecutive hypertensive patients, hospitalized in our department between May 2017 and April 2018, were included. They were divided into two groups based on the gold standard echocardiogram: those with (n = 116) and without LVH (n = 119). The newly proposed ECG criteria were calculated by summating the amplitude of the deepest S wave (S _D ) in any single lead and the S-wave amplitude of lead V ₄ (S _V4 ). The area under the curve was calculated and compared against the sex-specific Cornell limb lead and Sokolow–Lyon criteria. Results: ECG analysis of the cohort showed that the newly proposed criteria had the highest sensitivity in diagnosing LVH (male: 65.5%; female: 81%), followed by the Cornell limb lead criteria (male: 55.2%; female: 56.9%). The specificities of both sets of criteria were higher than 70%, with no significant differences between them. Receiver operator curve analysis showed an optimal cutoff of ≥2.1 mV for females (AUC: 0.832; 95% CI: 0.757–0.906) and ≥2.6 mV for males (AUC: 0.772; 95% CI: 0.687–0.856). Conclusion: The newly proposed S _D  + S _V4 criteria provide an improved sensitivity for the ECG diagnosis of LVH compared to existing criteria, but its routine use will require further validation in larger populations.