Objective: To determine, in Black Africans, the performance of routine electrocardiographic criteria in the diagnosis of left ventricular hypertrophy (LVH).
Methods: Thirty voluntary healthy subjects and 154 patients were explored at echocardiography (according to Pen convention) and 12-lead electrocardiography (ECG). The performance of Lewis, Sokolow and Cornell (Cornell S1 for a threshold of 28 mm in men, and Cornell S2, for a threshold of 24 mm) criteria were defined by their sensitivity, specificity, positive and negative predictive values.
Results: The prevalence of LVH in the 154 patients ranged from 15.6% to 35.7%, according to the ECG criteria. Sensitivities were of 0.19, 0.43, 0.30 and 0.76 for the Lewis, Sokolow, Cornell S1 respectively, and the specificities were of 0.89, 0.73, 0.91 and 0.54. Positive predictive value ranged from 0.16 (Cornell S2) to 0.91 (Cornell S2), and the negative predictive value, from 0.48 (Lewis) to 0.86 (Cornell S2).
Conclusion: Routine ECG criteria for the diagnosis LVH have low performance in Black African. There is a need of new ECG criteria with better performance.