Abstract 17794: Correlation of ECG Voltages to Echocardiographic LV Mass in a Large Athletic Adolescent Screening Program
Background: In an attempt to detect underlying disease processes that may place adolescent athletes at risk for sudden cardiac death, some have advocated for population based ECG screening. Controversy exists over ECG screening secondary to the lack of specificity and the detrimental effects of potential false positive outcomes. The purpose of this study was to determine the relationship between precordial lead voltage on ECG and left ventricular mass (LVM) by echocardiogram in an effort to aid future research endeavors that attempt to identify at-risk patients.
Objectives: To analyze the correlation between left ventricular voltages and other ECG characteristics with LVM by echocardiogram.
Methods: This was a retrospective cohort analysis of a prospectively obtained population of self-identified adolescent athletes who underwent sports screening with ECG and echocardiogram. Correlations were performed between ECG voltages (R wave V6, S wave V1 and R wave V6 + S wave V1) and echocardiogram based measurements of mass including: LVM, LVM/m2 and LVM/height2.7.
Results: 659 adolescent athletes enrolled in this study (64% male). The mean age was 15.4 years (14-18). Correlations between echo LVM and R Wave in V6, S Wave in V1, and R Wave in V6 + S Wave in V1 were all less than 0.20 (Figure 1). LVH by ECG was seen in 4% of patients and 3% of patients had LVH by echocardiogram, none of which were correlative. The presence or absence of significant ST segment or t-wave abnormalities or q-waves on ECG did not improve ECG testing characteristics.
Conclusions: There is poor correlation between non-indexed LV ECG voltages and echocardiographic measures of LVM in adolescent athletes, which may account for previous reports of poor ECG testing characteristics. Whether indexing ECG values to patient based characteristics will improve ECG as a screening testing modality needs to be evaluated.
- © 2013 by American Heart Association, Inc.