Study on the diagnostic accuracy of left atrial enlargement by resting electrocardiography and its echocardiographic correlation.

M-mode echocardiography has been accepted as gold standard for measuring left atrial (LA) size. Electrocardiography (ECG) offers a simple, non-invasive, cost-effective and reproducible method to assess LA size and it is mostly in agreement with echocardiography though discrepancies exist. ECGs and echocardiograms were obtained in 100 consecutive patients suspected of having left atrial enlargement due to different underlying heart diseases. The diagnostic accuracy of six ECG criteria of LA enlargement were evaluated comparing with LA size in M-mode echo study. Various criteria were found to be poor to mildly sensitive (8% to 78%) but highly specific (85% to 100%) for left atrial enlargement. Morris Index (PTFV1) was found to be the best criterion having 76% sensitivity and 92% specificity. Combination of criteria enhances the sensitivity at the cost of specificity. Overall predictive index of electrocardiogram for left atrial enlargement is not encouraging.

[1]  C. Appleton,et al.  Relation of electrocardiographic criteria for left atrial enlargement to two-dimensional echocardiographic left atrial volume measurements. , 2007, The American journal of cardiology.

[2]  D. Meyers,et al.  P-wave morphology correlation with left atrial volumes assessed by 2-dimensional echocardiography. , 2006, Journal of electrocardiology.

[3]  T. Marwick,et al.  Diagnostic accuracy of the resting electrocardiogram in detection and estimation of left atrial enlargement: an echocardiographic correlation in 551 patients. , 1991, American heart journal.

[4]  W. Kostuk,et al.  Atrial and ventricular arrhythmias in asymptomatic active elderly subjects: correlation with left atrial size and left ventricular mass. , 1990, American heart journal.

[5]  S. Kothari,et al.  Electrocardiographic left atrial enlargement--correlation with echo. , 1989, The Journal of the Association of Physicians of India.

[6]  Daniel B Hier,et al.  Atrial size, atrial fibrillation, and stroke , 1986, Annals of neurology.

[7]  M A Alpert,et al.  Sensitivity and specificity of commonly used electrocardiographic criteria for left atrial enlargement determined by M-mode echocardiography. , 1984, The American journal of cardiology.

[8]  E. Krongrad,et al.  Assessment of electrocardiographic criteria for left atrial enlargement in childhood. , 1984, The American journal of cardiology.

[9]  M. Josephson,et al.  Electrocardiographic left atrial enlargement. Electrophysiologic, echocardiographic and hemodynamic correlates. , 1977, The American journal of cardiology.

[10]  M. Quiñones,et al.  Left Atrial Enlargement: Echocardiographic Assessment of Electrocardiographic Criteria , 1976, Circulation.

[11]  S. Rubler,et al.  Comparison of left atrial size and pulmonary capillary pressure with P wave of electrocardiogram. , 1976, American heart journal.

[12]  W. Henry,et al.  Relation between Echocardiographically Determined Left Atrial Size and Atrial Fibrillation , 1976, Circulation.

[13]  W. Frankl,et al.  Electrocardiographic detection of left atrial enlargement. Correlation of P wave with left atrial dimension by echocardiography. , 1975, British heart journal.

[14]  Lee Yc,et al.  Echocardiographic and electrocardiographic criteria for diagnosing left atrial enlargement. , 1975 .

[15]  P. Probst,et al.  Investigation of atrial aberration as a cause of altered P wave contour. , 1973, American heart journal.

[16]  R. C. Scott,et al.  Morphologic significance of left atrial involvement. , 1972, American heart journal.

[17]  H. Feigenbaum,et al.  Estimation of left atrial size using ultrasound. , 1969, American heart journal.

[18]  J. W. Kennedy,et al.  The Relationship of Increased Left Atrial Volume and Pressure to Abnormal P Waves on the Electrocardiogram , 1969, Circulation.

[19]  J. Calatayud,et al.  Evaluation of ECG criteria for P-wave abnormalities. , 1967, American heart journal.

[20]  L. Wolff,et al.  Correlation between Component Cardiac Weights and Electrocardiographic Patterns in 185 Cases , 1964, Circulation.

[21]  H. Thompson,et al.  P-WAVE ANALYSIS IN VALVULAR HEART DISEASE. , 1964 .

[22]  H. Zimmerman,et al.  Auricular overloadings; electrocardiographic analysis of 193 cases. , 1959, The American journal of cardiology.

[23]  J. Perloff,et al.  A Method for the Electrocardiographic Recognition of Atrial Enlargement , 1958, Circulation.

[24]  L. Soloff,et al.  RELATIONSHIP OF THE P WAVE TO LEFT ATRIAL VOLUME IN RHEUMATIC HEART DISEASE WITH MITRAL STENOSIS , 1958, The American journal of the medical sciences.

[25]  A. Master,et al.  MITRAL STENOSIS: A CORRELATION OF ELECTROCARDIOGRAPHIC AND PATHOLOGIC OBSERVATIONS , 1938 .