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

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 (RV 6 , SV 1 , RV 6 +SV 1 , QV 6 , and Q III >98% for age, R/SV 1 6 ) 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, ≤6 years old, and similarly assessed. Results The sensitivity rate was Conclusion The ECG is a poor screening tool for identifying LVH in children. Sensitivity is not improved with revision of current criteria. (Am Heart J 2003;145:716-23.)