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

• Published in: The American journal of cardiology Vol. 117; no. 11; pp. 1831 - 1835
• Main Authors: Leigh, J. Adam, O'Neal, Wesley T., Soliman, Elsayed Z.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016; Elsevier Limited
• Subjects: Age Factors; Aged; Aged, 80 and over; Angina pectoris; Body mass index; Cardiovascular disease; Cholesterol; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary Disease - physiopathology; Diabetes; Echocardiography; Education; Electrocardiography; Electrocardiography - methods; Female; Follow-Up Studies; Gender; Health risk assessment; Heart attacks; Heart failure; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - epidemiology; Hypertrophy, Left Ventricular - physiopathology; Incidence; Male; Methods; Population Surveillance - methods; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Factors; Sex Factors; Stroke; Stroke - diagnosis; Stroke - epidemiology; Stroke - physiopathology; Ultrasonic imaging; United States - epidemiology; Variables; North Carolina
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.03.020

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/m2; female: >88 g/m2). 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.