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Left ventricular hypertrophy and cardiovascular disease risk prediction and reclassification in blacks and whites:

Tochi M Okwuosa1, Elsayed Z Soliman2, Faye Lopez3

  • 1Rush University School of Medicine, Chicago, IL.

American Heart Journal
|December 16, 2014
PubMed

Insights

Electrocardiography-determined left ventricular hypertrophy (ECG-LVH) is linked to cardiovascular disease (CVD) and coronary heart disease (CHD) risk. However, it did not significantly improve risk prediction in black or white individuals beyond existing equations.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Medical Diagnostics

Background:

  • Left ventricular hypertrophy (LVH) is a key predictor of cardiovascular disease (CVD) survival.
  • LVH is more common in Black individuals compared to White individuals.
  • Electrocardiography (ECG) is a common diagnostic tool for assessing cardiac health.

Purpose of the Study:

  • To assess if ECG-determined LVH (ECG-LVH) can improve CVD and coronary heart disease (CHD) risk prediction.
  • To evaluate ECG-LVH's reclassification ability beyond traditional risk factors in a biracial population.
  • To determine if ECG-LVH offers additional predictive value in Black and White participants.

Main Methods:

  • Analysis of 14,489 participants from the ARIC cohort with 10-year follow-up.
  • Utilized 10-year Pooled Cohort and Framingham risk equations for CVD and CHD risk prediction.
  • Incorporated 10 traditional ECG-LVH criteria into risk models to calculate Net Reclassification Improvement (NRI).

Main Results:

  • ECG-LVH was associated with increased risk of CVD and CHD events (HR 1.62 and 1.56, respectively).
  • ECG-LVH did not significantly improve the C-statistic or reclassify risk in the overall cohort.
  • No significant racial interactions were observed in the reclassification analysis.

Conclusions:

  • ECG-LVH is associated with higher CVD and CHD risk.
  • ECG-LVH does not significantly enhance risk prediction beyond current Pooled Cohort and Framingham equations.
  • The findings apply to both Black and White participants in the studied cohort.
Abstract

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