CARDIAC MRI DERIVED LEFT VENTRICULAR MASS INDICES CORRELATE MODERATELY WITH ECG HYPERTROPHY SCORES IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

Background: Left ventricular hypertrophy (LVH) is a hallmark of hypertrophic cardiomyopathy (HCM), the magnitude of which has been shown to harbour prognostic significance. Measuring the real degree of LVH has become feasible with the use of cardiac magnetic resonance imaging (CMR).
Aims: We thought to correlate ECG hypertrophy scores and CMR derived LVH indices in patients with HCM.
Materials and methods: Thirty patients with HCM were studied (23 males, age: 43±16 years, maximal left ventricular wall thickness: 28±6 mm). Patients underwent CMR imaging according to standard methods. Left ventricular mass (LVM) was calculated from the images and were indexed to body height (LVMiH), body weight (LVMiW), body surface area (LVMiBSA) and body mass index (LVMiBMI). ECG hypertrophy scores (maximal R or S voltage, total voltage score, Sokolow-Lyon score, Cornell score, Romhilt-Estes score) and score products (score x QRS duration) were calculated from quality 12-lead surface ECG recordings.
Results: Maximal R or S voltage scores were significantly related to all LVM indices and the best correlation was found between maximal R or S voltage score and LVMiBMI (r= 0.667, p<0.001). Cornell and Romhilt-Estes scores did not correlate significantly with LVM indices. Apart of LVMiH, the level of correlation increased with indexation and LVMiBMI showed the largest number of significant correlations. ECG score products did not show better correlation values than ECG scores alone.
Conclusion: Among traditionally used ECG scores of hypertrophy the maximal R or S voltage score shows the best, albeit moderate correlation with CMR derived indices of left ventricular hypertrophy in patients with HCM.