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Differences in cardiovascular risk profile between electrocardiographic hypertrophy versus strain in asymptomatic

Anders M Greve1, Eva Gerdts, Kurt Boman

  • 1Department of Medicine B, The Heart Center, Rigshospitalet, Copenhagen, Denmark. greve_anders@hotmail.com

The American Journal of Cardiology
|June 1, 2011
PubMed

Insights

Electrocardiograms reveal that left ventricular hypertrophy and strain are linked to aortic stenosis severity. These findings clarify the clinical value of ECGs in managing aortic stenosis patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Clinical Research

Background:

  • Electrocardiograms (ECGs) are standard for monitoring asymptomatic aortic stenosis (AS).
  • The relationship between ECG findings, left ventricular (LV) response to pressure overload, and clinical factors in AS is not fully understood.
  • The clinical utility of routine ECGs in AS management remains uncertain.

Purpose of the Study:

  • To investigate the association between electrocardiographic criteria for LV hypertrophy and strain with AS severity and LV mass.
  • To explore differences in clinical covariates among patients with varying ECG findings.

Main Methods:

  • Analysis of data from 1,563 patients in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study.
  • ECG data were Minnesota coded for arrhythmias and blocks; LV hypertrophy was assessed using Sokolow-Lyon and Cornell criteria.
  • AS severity was measured by echocardiographic peak aortic jet velocity; LV mass was indexed by body surface area.

Main Results:

  • Higher peak aortic jet velocity correlated with ECG strain and LV hypertrophy (Sokolow-Lyon criteria) after adjustments.
  • Increased LV mass index was associated with ECG strain and both LV hypertrophy criteria after adjustments.
  • ECG strain was linked to higher peak aortic jet velocity, blood glucose, and uric acid; LV hypertrophy criteria showed associations with age and gender.

Conclusions:

  • ECG criteria for LV hypertrophy and strain are independently associated with AS severity (peak aortic jet velocity) and LV mass.
  • Distinct clinical covariates are associated with ECG strain versus LV hypertrophy by Sokolow-Lyon and Cornell criteria.
  • ECG findings provide valuable prognostic information in patients with aortic stenosis.

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