Electrocardiographic Criteria of Left Ventricular Hypertrophy in Patients with Morbid Obesity

Background: Obesity is frequently accompanied by systemic hypertension complicated by left ventricular hypertrophy (LVH). Standard electrocardiography (ECG) is generally accepted screening tool for LVH in systemic hypertension. The aim was to assess currently used ECG criteria in the diagnosis of LVH in morbidly obese patients. Methods: Ninety-five patients (80 women, 15 men) with body mass index >= 40 kg/m(2), prior to scheduled bariatric surgery were included into the study. All patients underwent standard ECG and transthoracic ECG for LVH assessment. Results: Echocardiographically LVH (> 110 g/m(2) in women, and > 132 g/m(2) in men) was diagnosed in 54 patients (56.8%). None of the ECG criteria showed satisfactory performance in the diagnosing echocardiographically confirmed LVH. Although, Receiving operating curves (ROC) analysis showed that only Romilht-Estes score and Cornell index x QRS complex duration were characterized by area under curve > 0.6 (0.662; 0.612, respectively), currently recommended values of both tests (Romilht-Estes score and Cornell index x QRS duration 2436 mm.ms) showed very low sensitivity in morbidly obese patients (0% and 2%, respectively). Conclusions: Our study showed that none of voltage-based ECG criteria are of value for LVH diagnosis in severely obese patients. Only Romhilt-Estes scale and Cornell indices could be helpful for the identification of LVH in the group of patients with morbid obesity, but their value is far from being satisfactory.