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Comparative Study
. 2021 Sep;8(2):e001765.
doi: 10.1136/openhrt-2021-001765.

Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes

Yuta Seko  1 , Takao Kato  2 , Yuhei Yamaji  3 , Yoshisumi Haruna  3 , Eisaku Nakane  3 , Tetsuya Haruna  3 , Moriaki Inoko  3
Affiliations
Comparative Study

Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes

Yuta Seko et al. Open Heart. 2021 Sep.

Abstract

Background: The clinical significance of the discrepancy between left ventricular hypertrophy (LVH) by echocardiography and ECG remains to be elucidated.

Methods: After excluding patients who presented with pacemaker placement, QRS duration ≥120 ms and cardiomyopathy and moderate to severe valvular disease, we retrospectively analysed 3212 patients who had undergone both scheduled transthoracic echocardiography (echo) and ECG in a hospital-based population. Cornell product >2440 mm · ms was defined as ECG-based LVH; left ventricular mass index >115 g/m2 for men and >95 g/m2 for women was defined as echo-based LVH. The study population was categorised into four groups: patients with both ECG-based and echo-based LVH (N=131, 4.1%), those with only echo-based LVH (N=156, 4.9%), those with only ECG-based LVH (N=409, 12.7%) and those with no LVH (N=2516, 78.3%).

Results: The cumulative 3-year incidences of a composite of all-cause death and major adverse cardiovascular events were 32.0%, 33.8%, 19.2% and 15.7%, respectively. After adjusting for confounders, the HRs relative to that in no LVH were 1.63 (95% CI 1.16 to 2.28), 1.68 (95% CI 1.23 to 2.30) and 1.09 (95% CI 0.85 to 1.41) in patients with both ECG-based and echo-based LVH, those with only echo-based LVH, and those with only ECG-based LVH, respectively.

Conclusions: Echo-based LVH without ECG-based LVH was associated with a significant risk of adverse clinical events, and the risk was comparable to that in patients with both echo-based and ECG-based LVH.

Keywords: diagnostic imaging; echocardiography; electrocardiography.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Patient flowchart. LVH, left ventricular hypertrophy; TTE, transthoracic echocardiography.
Figure 2
Figure 2
Cumulative incidence of the primary outcome measure (a composite of all-cause death or MACE) and secondary outcomes measure (all cause death, MACE). (A) a composite of all-cause death or MACE, (B) all-cause death, (C) MACE. LVH, left ventricular hypertrophy; MACE, major adverse cardiovascular event.
See this image and copyright information in PMC

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