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Published on: October 28, 2020

Prognostic value of electrocardiographic criteria for left ventricular hypertrophy

Bill P Hsieh1, Michael X Pham, Victor F Froelicher

  • 1Division of Cardiovascular Medicine, Stanford University School of Medicine, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA.

American Heart Journal
|August 9, 2005
PubMed

Insights

Composite electrocardiogram (ECG) criteria for left ventricular hypertrophy (LVH) better predict cardiovascular (CV) mortality than voltage-only methods. Identifying high-risk patients with LVH using these ECG criteria can improve CV mortality outcomes.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Public Health

Background:

  • Electrocardiogram (ECG) criteria for left ventricular hypertrophy (LVH) are numerous.
  • The comparative prognostic value of these ECG criteria for cardiovascular (CV) mortality is not well-established.

Purpose of the Study:

  • To compare the prognostic value of 17 common ECG criteria for LVH in predicting CV mortality.
  • To identify which ECG criteria are most effective in identifying patients at high risk for CV death.

Main Methods:

  • Analysis of ECGs from 46,950 consecutive male veterans with body mass index > 20.
  • Exclusion of patients with complicating illnesses or conduction abnormalities.
  • Cox regression models adjusted for age, heart rate, and body mass index to compare hazard ratios (HRs) for CV mortality.

Main Results:

  • During a mean follow-up of 7 years, 1254 (6%) of 19,434 patients died of CV causes.
  • Adjusted HRs for CV mortality varied from 1.4 to 3.7 across different ECG criteria.
  • Composite ECG criteria for LVH showed higher adjusted HRs than voltage-only criteria.
  • Left ventricular strain pattern and increased negative P-terminal force were the most predictive of CV mortality (HRs 3.9 and 3.5, respectively).

Conclusions:

  • Composite ECG criteria for LVH are more strongly predictive of CV mortality than voltage-only criteria.
  • Routine application of these composite ECG criteria can help identify high-risk individuals for timely intervention and improved outcomes.
Abstract

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