Document Detail


Electrocardiographic and echocardiographic detection of myocardial infarction in patients with left-ventricular hypertrophy. The LIFE Study.
MedLine Citation:
PMID:  17586412     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left-ventricular hypertrophy (LVH) is a recognized risk factor for myocardial infarction (MI). However, detection of MI by standard electrocardiographic (ECG) criteria may be hampered in patients with LVH. In this setting of hypertensive LVH, the accuracy of two-dimensional (2D) echocardiography in detecting incident MI is unknown. Thus, we compared the accuracy of 2D echocardiography with Minnesota-code ECG criteria in detecting incident MI, adjudicated during serial evaluation in patients with hypertension and LVH. METHODS: In the ECG substudy of the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study, complete baseline wall-motion (WM) evaluation was obtained in 904 hypertensive patients with ECG LVH who did not have a left-bundle branch block. Electrocardiography and echocardiograms obtained at annual follow-up visits were evaluated for ECG Q-waves by Minnesota codes and WM abnormalities, respectively (mean follow-up, 4.8+/-0.9 SD years). Occurrence of incident clinical MI during follow-up was adjudicated by an expert end-point committee. RESULTS: In two logistic models adjusting for confounders, incident MI was independently associated with either incident Q-waves by the Minnesota code (odds ratio [OR], 6.1; 95% confidence interval [CI], 2.4-15.3) or incident and worsened WM abnormalities (OR, 11.9; 95% CI, 4.5-32.0), and the association was stronger for WM abnormalities than for Q-waves (P < .0001). Detection of incident MI by ECG or 2D echocardiography was obtained with sensitivities of 29% and 68% and specificities of 95% and 84%, respectively. CONCLUSIONS: Wall-motion abnormalities on serial 2D ECGs recognize incident MI better than do Minnesota-code ECG criteria during follow-up of patients with hypertension and LVH.
Authors:
Silvana Cicala; Richard B Devereux; Giovanni de Simone; Kristian Wachtell; Eva Gerdts; Kurt Boman; Markku S Nieminen; Vasilios Papademetriou; Björn Dahlöf; Peter M Okin
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of hypertension     Volume:  20     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-11-01     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  771-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Weill Medical College of Cornell University, New York, NewYork 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Echocardiography
Electrocardiography
Female
Humans
Hypertension / complications*
Hypertrophy, Left Ventricular / complications*
Logistic Models
Male
Middle Aged
Myocardial Infarction / diagnosis*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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