Questionable validity of left ventricular hypertrophy cutoff values in morbidly and super-morbidly obese patients

BACKGROUND: Current diagnostic ECG criteria of left ventricular hypertrophy in obese patients are still lacking. OBJECTIVE: To assess the current ECG diagnostic criteria of LVH, and to validate our previously proposed criteria in a group of patients with morbid obesity. METHODS: A group of consecutive 429 obese patients (MOP) with BMI of at least 35 kg/m2 (mean age 38.6 ± 8.9 years, BMI 48.7 ± 9.0 kg/m2 ; 323 females, 106 males) were included. RESULTS: The diagnosis of LVH in MOPs was confirmed only by RaVL of 7.5 mm, Cornell index of 12.5 mm; Cornell index × QRS duration of 1,125 mm × ms and Romhilt-Estes score of 1. None of the criteria proposed to date is appropriate in super-morbidly obese patients. CONCLUSION: Our study confirmed that none of the currently used voltage-based ECG criteria is appropriate for diagnosing LVH in morbidly obese patients. Further studies are required.