This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okin, P. M. Articles by Kligfield, P. Search for Related Content PubMed PubMed Citation Articles by Okin, P. M. Articles by Kligfield, P.

(Hypertension. 1995;25:242-249.)
© 1995 American Heart Association, Inc.

Articles

Gender Differences and the Electrocardiogram in Left Ventricular Hypertrophy

Peter M. Okin; Mary J. Roman; Richard B. Devereux; Paul Kligfield

From the Division of Cardiology, Department of Medicine, The New York Hospital–Cornell Medical Center (NY).

Abstract We examined the relations of gender differences in electrocardiographic (ECG) voltages and QRS duration to differences in cardiac dimensions and body size between men and women and gender differences in test performance of ECG criteria for the detection of echocardiographic left ventricular hypertrophy in 389 subjects (112 women and 277 men). ECG voltage-duration products were calculated as the product of QRS duration and voltages. Among subjects with normal left ventricular mass and also among subjects with left ventricular hypertrophy, men had longer QRS duration, higher Cornell voltage, higher 12-lead sum of QRS voltage, and higher Cornell and 12-lead voltage-duration products than did women. Significant gender differences in QRS duration, Cornell voltage, the 12-lead sum of voltage and their voltage-duration products remained after adjusting for the greater left ventricular mass, height, and weight in men than women. Comparison of areas under receiver operating characteristic curves using gender-specific criteria demonstrated higher performance of QRS duration, Cornell voltage, the 12-lead sum of QRS voltage, and the respective voltage-duration products for the identification of left ventricular hypertrophy in men than women. Thus, gender differences in body size and left ventricular mass do not completely account for gender differences in QRS duration and voltage measurements, and ECG criteria for left ventricular hypertrophy have lower accuracy in women even when gender differences in partition value selection are taken into account. These findings indicate a need for new, more accurate, and gender-specific ECG criteria for the detection of hypertrophy and suggest that factors other than left ventricular dimensions and body size may play a role in the observed differences in QRS voltages and durations between men and women.

Key Words: electrocardiography • hypertrophy, left ventricular • gender

This article has been cited by other articles:

				I. Ostman-Smith, A. Wisten, E. Nylander, E.-L. Bratt, A. de-Wahl Granelli, A. Oulhaj, and E. Ljungstrom Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy Eur. Heart J., November 5, 2009; (2009) ehp443v1. [Abstract] [Full Text] [PDF]

				P. M. Okin, E. Gerdts, S. E. Kjeldsen, S. Julius, J. M. Edelman, B. Dahlof, R. B. Devereux, and for the Losartan Intervention for Endpoint Reducti Gender Differences in Regression of Electrocardiographic Left Ventricular Hypertrophy During Antihypertensive Therapy Hypertension, July 1, 2008; 52(1): 100 - 106. [Abstract] [Full Text] [PDF]

				T. A. Aksnes, S. E. Kjeldsen, M. Rostrup, P. Omvik, T. A. Hua, and S. Julius Impact of New-Onset Diabetes Mellitus on Cardiac Outcomes in the Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) Trial Population Hypertension, September 1, 2007; 50(3): 467 - 473. [Abstract] [Full Text] [PDF]

				P. M. Okin Electrocardiography in Women: Taking the Initiative Circulation, January 31, 2006; 113(4): 464 - 466. [Full Text] [PDF]

				E. Biagini, A. Elhendy, A. F.L. Schinkel, S. Nelwan, V. Rizzello, R. T. van Domburg, C. Rapezzi, G. Rocchi, M. L. Simoons, J. J. Bax, et al. Prognostic Significance of Left Anterior Hemiblock in Patients With Suspected Coronary Artery Disease J. Am. Coll. Cardiol., September 6, 2005; 46(5): 858 - 863. [Abstract] [Full Text] [PDF]

				K. Alfakih, K. Walters, T. Jones, J. Ridgway, A. S. Hall, and M. Sivananthan New Gender-Specific Partition Values for ECG Criteria of Left Ventricular Hypertrophy: Recalibration Against Cardiac MRI Hypertension, August 1, 2004; 44(2): 175 - 179. [Abstract] [Full Text] [PDF]

				P. M. Okin, R. B. Devereux, S. Jern, S. E. Kjeldsen, S. Julius, and B. Dahlof Baseline Characteristics in Relation to Electrocardiographic Left Ventricular Hypertrophy in Hypertensive Patients : The Losartan Intervention For Endpoint Reduction (LIFE) in Hypertension Study Hypertension, November 1, 2000; 36(5): 766 - 773. [Abstract] [Full Text] [PDF]

				B. Dahlof, R. B. Devereux, S. Julius, S. E. Kjeldsen, G. Beevers, U. de Faire, F. Fyhrquist, T. Hedner, H. Ibsen, K. Kristianson, et al. Characteristics of 9194 Patients With Left Ventricular Hypertrophy : The LIFE Study Hypertension, December 1, 1998; 32(6): 989 - 997. [Abstract] [Full Text] [PDF]

				P. M. Okin, M. J. Roman, R. B. Devereux, T. G. Pickering, J. S. Borer, and P. Kligfield Time-Voltage QRS Area of the 12-Lead Electrocardiogram : Detection of Left Ventricular Hypertrophy Hypertension, April 1, 1998; 31(4): 937 - 942. [Abstract] [Full Text] [PDF]

				P. M. Okin, M. J. Roman, R. B. Devereux, and P. Kligfield Time-Voltage Area of the QRS for the Identification of Left Ventricular Hypertrophy Hypertension, February 1, 1996; 27(2): 251 - 258. [Abstract] [Full Text]