Document Detail


Impact of Left Ventricular Hypertrophy on QT Prolongation and Associated Mortality.
MedLine Citation:
PMID:  24956189     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: QT prolongation on ECG is a risk marker of ventricular arrhythmias and all-cause mortality. Left ventricular hypertrophy (LVH) on ECG is also associated with poor outcome. Patients satisfying ECG voltage criteria for LVH frequently show concomitant QT prolongation.
OBJECTIVE: To explore the impact of marked QT prolongation on all-cause mortality in patients co-presenting with LVH voltage and prolonged QT on electrocardiogram (ECG).
METHODS: We evaluated 3364 ECGs with QTc ≥460ms detected by Mayo Clinic's QT alert system from November 2010 through June 2011. Every ECG with QTc ≥460ms was evaluated for presence of LVH criteria by Sokolow Lyon, Cornell voltage, and product.
RESULTS: Concomitant LVH voltage criteria were present in 181/3364 (5.3%) of ECGs with QTc ≥ 460ms. Mortality during follow up of 217 ± 184 days was 13% (23/181). Independent of age and hypertension, among patients with LVH, QTc predicted mortality (HR 1.31 per 10ms increase; 95% CI 1.09-1.58, p<0.01). Patients with voltage criteria for LVH and QTc ≥500ms had highest mortality (log rank < 0.001).
CONCLUSION: QTc was an independent predictor of mortality in patients with concomitant LVH voltage and prolonged QTc on ECG. Mortality was highest in those with QTc ≥500ms. QT prolongation in ECGs with concomitant LVH should not be regarded as a harmless byproduct of LVH, but should be used as a significant marker of increased mortality risk similar to patients without LVH.
Authors:
Kristina H Haugaa; J Martijn Bos; Evan Borkenhagen; Robert F Tarrell; Bruce W Morlan; Pedro J Caraballo; Michael J Ackerman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-20
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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