PURPOSE: To compare the efficacy of four electrocardiographic criteria: Sokolov, Gubner, Cornell and Romhilt indexes, in the diagnosis of left ventricular hypertrophy (LVH) in hypertensive patients. METHODS: LVH was analyzed in the eletrocardiogram of 30 ambulatory patients presenting with systemic arterial hypertension, classified as mild, moderate and severe, according to the following indexes: Sokolov >35mm, Gubner >22mm, Romhilt >5 points and Cornell >20mm for women and 28mm for men. Sensitivity, specificity, diagnostic accuracy and other diagnostic variables were determined. Mass index of the left ventricle, >98g/m² for women and >120g/m² for men, obtained by echocardiography, was considered the gold standard for the diagnosis of LVH. RESULTS: When electrocardiographic criteria were considered separately, the Sokolov index showed the highest accuracy, with a sensitivity of 40%, diagnostic accuracy of 50% and specificity of 100%; the second most accurate index was Gubner, and Romhilt and Cornell indexes followed. When at least one of the indexes was positive, the sensitivity was 52% and diagnostic accuracy was 57%. CONCLUSION: The four electrocardiographic indexes were not diagnostic of LVH, when analyzed either separately or together. Considering the high prevalence of this pathological condition, we conclude that a more accurate diagnostic method should be used in this diagnosis.
left ventricular hypertrophy; electrocardiography; hypertension
