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Comparative Study
. 2016 Jun 1;117(11):1831-5.
doi: 10.1016/j.amjcard.2016.03.020. Epub 2016 Mar 19.

Electrocardiographic Left Ventricular Hypertrophy as a Predictor of Cardiovascular Disease Independent of Left Ventricular Anatomy in Subjects Aged ≥65 Years

J Adam Leigh  1 , Wesley T O'Neal  2 , Elsayed Z Soliman  3
Affiliations
Comparative Study

Electrocardiographic Left Ventricular Hypertrophy as a Predictor of Cardiovascular Disease Independent of Left Ventricular Anatomy in Subjects Aged ≥65 Years

J Adam Leigh et al. Am J Cardiol. .

Abstract

Left ventricular hypertrophy (LVH) diagnosed by electrocardiography (ECG-LVH) and echocardiography (echo-LVH) are independently associated with an increased risk of cardiovascular disease (CVD) events. However, it is unknown if ECG-LVH retains its predictive properties independent of LV anatomy. We compared the risk of CVD associated with ECG-LVH and echo-LVH in 4,076 participants (41% men, 86% white) from the Cardiovascular Health Study, who were free of baseline CVD. ECG-LVH was defined with Minnesota ECG Classification criteria from baseline ECG data. Echo-LVH was defined by gender-specific LV mass values normalized to body surface area (male: >102 g/m(2); female: >88 g/m(2)). ECG-LVH was detected in 144 participants (3.5%) and echo-LVH in 430 participants (11%). Over a median follow-up of 10.6 years, 2,274 CVD events occurred. In a multivariate Cox regression analysis adjusted for common CVD risk factors, ECG-LVH (hazard ratio [HR] 1.84, 95% CI 1.51 to 2.24) and echo-LVH (HR 1.35, 95% CI 1.19 to 1.54) were associated with an increased risk for CVD events. The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR 1.76, 95% CI 1.45 to 2.15). In conclusion, the association of ECG-LVH with CVD events is not dependent on echo-LVH. This finding provides support to the concept that ECG-LVH is an electrophysiological marker with predictive properties independent of LV anatomy.

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Conflict of interest statement

Disclosures: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cumulative Incidence of Cardiovascular Disease by ECG-LVH* *The cumulative incidence curves are statistically different (log-rank p<0.0001). ECG-LVH=electrocardiographic left ventricular hypertrophy; LVH=left ventricular hypertrophy.
Figure 2
Figure 2
Cumulative Incidence of Cardiovascular Disease by echo-LVH* *The cumulative incidence curves are statistically different (log-rank p=0.0004). echo-LVH=echocardiographic left ventricular hypertrophy; LVH=left ventricular hypertrophy.
See this image and copyright information in PMC

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