Format

Send to

Choose Destination
Am Heart J. 2003 Apr;145(4):716-23.

Usefulness of the pediatric electrocardiogram in detecting left ventricular hypertrophy: results from the Prospective Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection (P2C2 HIV) multicenter study.

Author information

1
Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Tex 77030, USA. srivenes@bcm.tmc.edu

Abstract

BACKGROUND:

A shortcoming of the pediatric electrocardiogram (ECG) appears to be its inability to accurately detect left ventricular hypertrophy (LVH). This study prospectively assesses the usefulness of the pediatric ECG as a screening modality for LVH.

METHODS:

Concomitant echocardiograms and ECGs from a large cohort of children who were exposed to the human immunodeficiency virus (HIV; uninfected) and children who were infected with HIV were compared. By use of the values of Davignon et al, qualitative determination of LVH and quantitative criteria for LVH (RV6, SV1, RV6+SV1, QV6, and Q(III) >98% for age, R/SV1 <98% for age, and [-]TV6) were compared to body surface area adjusted for left ventricular (LV) mass z score. Results were then stratified according to weight and weight-for-height z scores. New age-adjusted predicted values were then constructed from children of a mixed race who were HIV-uninfected, < or =6 years old, and similarly assessed.

RESULTS:

The sensitivity rate was <20% for detecting increased LV mass, irrespective of HIV status; the specificity rate was 88% to 92%. The sensitivity rate of the individual criteria ranged from 0 to 35%; the specificity rate was 76% to 99%. Test sensitivities remained low when stratified by weight and weight-for-height z scores. Areas under the receiver operator characteristic curves were between 0.59 and 0.70, also suggesting poor accuracy of the ECG criteria. By use of new age-adjusted predicted values, the sensitivity rate decreased to <17%, and the specificity rate increased to 94% to 100%.

CONCLUSION:

The ECG is a poor screening tool for identifying LVH in children. Sensitivity is not improved with revision of current criteria.

PMID:
12679770
PMCID:
PMC4417742
DOI:
10.1067/mhj.2003.15
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center