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Relationship between electrocardiographic left ventricular hypertrophy criteria and vascular structure and function

M A Gómez-Marcos1, J I Recio-Rodríguez2, M C Patino-Alonso3

  • 1Department of Medicine, Primary Care Research Unit, La Alamedilla Health Center, SACYL, REDIAPP, IBSAL, Salamanca, Spain, University of Salamanca, Salamanca, Spain.

Journal of Human Hypertension
|September 20, 2013
PubMed

Insights

Electrocardiographic criteria for left ventricular hypertrophy (LVH) in hypertensive patients showed correlations with vascular changes, but these associations were influenced by age and medication.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Hypertension frequently leads to left ventricular hypertrophy (LVH).
  • Assessing LVH through electrocardiography (ECG) is crucial for cardiovascular risk stratification.
  • The relationship between ECG-detected LVH and objective measures of vascular health requires further investigation.

Purpose of the Study:

  • To identify the electrocardiographic (ECG) criterion for left ventricular hypertrophy (LVH) that best correlates with vascular structure and function parameters in hypertensive patients.
  • To evaluate the impact of age, sex, and antihypertensive drug treatment on these associations.

Main Methods:

  • A cross-sectional study of 347 hypertensive patients.
  • ECG was used to assess LVH using 10 criteria, including a defined voltage-duration product (VDP) complex.
  • Vascular structure (carotid intima-media thickness - C-IMT) and function (pulse wave velocity - PWV, augmentation indices - CAIx, PAIx, arterial stiffness indices - AASI) were measured.
  • Multivariate analyses were performed to adjust for confounding factors.

Main Results:

  • LVH was detected in 29.10% of patients by at least one ECG criterion.
  • Patients with ECG-detected LVH exhibited higher values for vascular structure and function parameters.
  • Specific ECG criteria showed varying correlations with different vascular parameters (e.g., Lewis-VDP with C-IMT, Framingham-adjusted Cornell voltage with PWV/AASI, Novacode with CAIx/PAIx).
  • Associations between ECG-LVH and vascular parameters diminished after adjusting for age, sex, and antihypertensive drugs.

Conclusions:

  • The relationship between ECG-detected LVH and vascular structure/function in hypertensive patients is significantly influenced by age and antihypertensive medication.
  • The predictive value of specific ECG criteria for vascular abnormalities is modulated by these demographic and treatment factors.
  • Further research is needed to understand the complex interplay of these factors in cardiovascular risk assessment.

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