Ventricular remodeling causes left ventricular hypertrophy in myocardial infarction patients. We hypothesised that left ventricular hypertrophy can be evaluated using isointegral body surface maps.

32 patients with an old myocardial infarction underwent 64-electrodes body surface mapping (isointegral QRS, QRST, ST and STT maps) and 12-lead ECG. 16 of them (50%) had left ventricular hypertrophy according to 8 electrocardiographic criteria (Romhilt-Estes scoring system, Sokolow-Lyon voltage, Gubner-Ungerleider voltage, Cornell voltage index, Cornell product, the diagnostic criteria based on the Framingham Heart Study data, Perugia score and Mazzaro score) and 2D-echocardiography.

Isointegral maxima increased and the minima was more negative in patients with left ventricular hypertrophy, and the differences were statistical significant for: isointegral QRS maxima (35±16 versus 60±21 mV.ms, p=0.0085) and minima (25±15 versus 69±14 mV.ms, p=0.0067), isointegral maxima and minima in the second third of the QRS complex, isointegral QRST minima (34±9 versus 49±5 mV.ms, p=0.042) and isointegral ST minima (5±2 versus 10±4 mV.ms, p=0.0026). Isointegral multipolar maps prevalence was increased in patients with left ventricular hypertrophy (75% versus 50%). Isointegral QRS and QRST maxima correlated best with left ventricular mass (r=0.73 and 0.81).

Body surface mapping is a useful method for the evaluation of patients with left ventricular hypertrophy. The most sensitive parameters are: isointegral QRS maxima and minima, especially in the second third of the QRS complex, isointegral QRST maps (minima, maxima and multipolarity) and isointegral ST minima.