Kühl JT, et al. - Researchers assessed cardiac computed tomography (CT) and electrocardiograms (ECG) with respect to the ability to detect left ventricular hypertrophy (LVH), in the Copenhagen General Population Study. The ultimate goal was to assess the value of CT assessment of LVH. Overall 4942 participants were included who underwent 12-lead ECG and cardiac CT and were assessed for the presence of LVH. On ECG and on CT, signs indicative of LVH were compared. Untreated hypertension was present in 1347, CT-detected anatomical LVH was present in 13% and 10% presented with anatomical LVH by ECG with an overlap of 4%. In 19% of hypertensive individuals, LVH was successfully detected using CT and ECG, with only a small diagnostic overlap. ECG signs of LVH, compared with CT, had negative predictive values between 87 and 89%. An increased C-statistics was achieved when a combination of the Sokolow-Lyon index, the Cornell voltage duration product and/or a Romhilt-Estes score at least 4 was used, compared with the use of any single ECG sign of LVH. The presence of anatomical LV organ damage could not be safely ruled out by commonly used ECG criteria for LVH.