| Prognostic value of electrocardiographic criteria for left ventricular hypertrophy. | |
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MedLine Citation:
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PMID: 16084164 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Many electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) exist, but few studies have compared their relative prognostic value for predicting cardiovascular (CV) mortality. METHODS: We analyzed the first ECG on 46950 consecutive veterans. We targeted male outpatients with a body mass index > 20 to avoid confounding by complicating catabolic illnesses and further excluded those with conduction abnormalities. Using Cox regression models adjusted for age, heart rate, and body mass index, we compared the hazard ratios (HRs) for CV mortality obtained from seventeen commonly used ECG criteria for LVH. RESULTS: During a mean follow-up of 7 +/- 4 years, in a total population of 19434 patients (mean age 54 +/- 14 years), 1254 (6%) patients died of CV causes. The adjusted HR for CV mortality ranged from 1.4 (95% CI 1.2-1.6) to 3.7 (95% CI 2.7-5.0) among the various criteria. Left ventricular hypertrophy defined by composite criteria was generally associated with higher adjusted HRs compared with voltage-only criteria. Among patients with ECG-LVH, the presence of a left ventricular strain pattern or increased negative P-terminal force were most predictive of CV mortality (HR 3.9 and 3.5, 95% CI 3.3-4.6 and 2.8-4.2). CONCLUSIONS: Compared with voltage-only criteria for detecting LVH, composite ECG criteria are more strongly predictive of CV mortality. By applying these ECG criteria into routine clinical practice, individuals with LVH who are at higher risk for CV mortality can be identified and appropriately treated. |
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Authors:
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Bill P Hsieh; Michael X Pham; Victor F Froelicher |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 150 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-08-08 Completed Date: 2005-11-28 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 161-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Medicine, Stanford University School of Medicine, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Electrocardiography* Humans Hypertrophy, Left Ventricular / diagnosis*, mortality* Male Middle Aged Prognosis |
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