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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
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Obesity and ECG left ventricular hypertrophy
Maria L Muiesan1, Massimo Salvetti, Augusto Di Castelnuovo
1aDepartment of Clinical & Experimental Sciences, University of Brescia, Brescia bDepartment of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo - NEUROMED, Pozzilli, Isernia, Italy cAMPS LLC, New York, New York, USA.
Journal of Hypertension
|September 24, 2016
Summary
Different electrocardiogram (ECG) criteria for left ventricular hypertrophy (LVH) show varying prevalence and predictive significance across body mass index (BMI) categories. The Cornell product criterion for ECG-LVH independently predicts cardiovascular events in normal weight and overweight individuals.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Public Health
Background:
- Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events.
- Prevalence and prognostic value of ECG-derived LVH criteria may vary with body mass index (BMI).
Purpose of the Study:
- To investigate the prevalence and prognostic significance of different ECG criteria for LVH in relation to BMI.
- To assess the association of ECG-LVH with cardiovascular events in normal weight, overweight, and obese adults.
Main Methods:
- Analysis of 18,330 adults from the Moli-sani cohort, defining obesity using ATPIII criteria.
- ECG-LVH defined per 2013 ESC-ESH guidelines; various criteria (Cornell-voltage, Sokolow-Lyon, aVL R-wave, Cornell product) assessed.
- Prognostic significance evaluated for fatal/nonfatal cerebrovascular and cardiovascular events, adjusting for confounders and BMI categories.
Main Results:
- ECG-LVH prevalence varied by criterion and BMI category; Cornell-voltage showed no difference, while Sokolow-Lyon decreased with increasing BMI.
- Cornell-voltage and Cornell product were associated with higher cardiovascular event incidence.
- After multivariable adjustment, only the Cornell product remained a significant predictor of cardiovascular events (HR 1.66).
- No ECG-LVH criteria predicted events in obese patients; Cornell product predicted events in normal weight (HR 2.63) and overweight (HR 2.72) individuals.
Conclusions:
- ECG-LVH prevalence and prognostic significance differ based on the criteria used and BMI categories.
- Utilizing BMI-specific LVH criteria may enhance cardiovascular risk stratification in the general population.
- The Cornell product criterion for ECG-LVH is a valuable independent predictor of cardiovascular events in non-obese individuals.
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