摘要：The sensitivity of electrocardiogram (ECG) criteria to detect left ventricular hypertrophy (LVH) is low, especially in women. We determined sex-specific sensitivities of ECG-LVH criteria, and developed new criteria, using cardiovascular magnetic resonance imaging (CMR). Sensitivities of ECG-LVH criteria were determined in participants of the UK Biobank (N = 3632). LVH was defined when left ventricular mass was > 95% confidence interval (CI) according to age and sex. In a training cohort (75%, N = 2724), sex-specific ECG-LVH criteria were developed by investigating all possible sums of QRS-amplitudes in all 12 leads, and selecting the sum with the highest pseudo-R
2 and area under the curve to detect LVH. Performance was assessed in a validation cohort (25%, N = 908), and association with blood pressure change was investigated in an independent cohort. Sensitivities of ECG-LVH criteria were low, especially in women. Newly developed
Groningen-LVH criterion for women (Q
V2 + R
I + R
V5 + R
V6 + S
V2 + S
V4 + S
V5 + S
V6) outperformed all ECG-LVH criteria with a sensitivity of 42% (95% CI 35–49%). In men, newly developed criterion ((R
I + R
V5 + S
II + S
V2 + S
V6) × QRS duration) was equally sensitive as 12-lead sum with a sensitivity of 44% (95% CI 37–51%) and outperformed the other criteria. In an independent cohort, the
Groningen-LVH criteria were strongest associated with change in systolic blood pressure. Our proposed CMR sex-specific
Groningen-LVH criteria improve the sensitivity to detect LVH, especially in women. Further validation and its association with clinical outcomes is warranted.
