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Risk of ventricular arrhythmias in left ventricular hypertrophy: the Framingham Heart Study
Insights
Left ventricular hypertrophy, a heart condition, significantly increases the risk of ventricular arrhythmias. Echocardiography is a more sensitive diagnostic tool for this association than electrocardiography, especially in women.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Medical Diagnostics
Background:
- Left ventricular hypertrophy (LVH) is a thickening of the heart's main pumping chamber.
- Ventricular arrhythmias are irregular heartbeats originating in the ventricles.
- The relationship between LVH and ventricular arrhythmias requires further investigation.
Purpose of the Study:
- To examine the association between left ventricular hypertrophy (LVH) and ventricular arrhythmias.
- To compare the diagnostic utility of electrocardiography (ECG) and echocardiography for detecting this association.
Main Methods:
- The Framingham Heart Study cohort (6,218 participants) was analyzed.
- Left ventricular hypertrophy was assessed using both ECG and echocardiography.
- Ventricular arrhythmias were graded and their association with LVH was statistically evaluated.
Main Results:
- Echocardiographic LVH showed a significant association with increased risk of ventricular arrhythmias in both men and women.
- ECG-detected LVH was associated with arrhythmias in men but not in women due to lower prevalence.
- The association between echocardiographic LVH and ventricular arrhythmias remained significant after adjusting for major cardiovascular risk factors.
Conclusions:
- Echocardiographic LVH is a more prevalent and sensitive indicator of ventricular arrhythmias compared to ECG-derived LVH.
- Echocardiography provides a more robust assessment of the risk posed by LVH to cardiac electrical stability.
Abstract:
The association of ventricular arrhythmias with left ventricular (LV) hypertrophy was examined in 6,218 participants in the Framingham Heart Study. Electrocardiographic (ECG) LV hypertrophy was present in 171 subjects and echocardiographic hypertrophy was detected in 869. Echocardiographic LV hypertrophy was associated with increased risk for each of 6 ventricular arrhythmia grades in men (relative risk up to 8.9, p less than 0.01), and 4 of 6 grades in women (p less than 0.05). Similarly, men with ECG LV hypertrophy were at increased risk for 4 of 6 arrhythmia grades (p less than 0.05). However, owing to low prevalence ECG LV hypertrophy was not associated with arrhythmia in women. After adjustment for age, sex, systolic blood pressure, valvular heart disease, angina pectoris and acute myocardial infarction, the association of echocardiographic but not ECG LV hypertrophy with ventricular arrhythmia remained significant (p less than 0.001). Thus, echocardiographic LV hypertrophy is more prevalent and more sensitive for ventricular arrhythmias than ECG LV hypertrophy.