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Absence of electrocardiographic left ventricular hypertrophy is associated with increased mortality after

Polydoros N Kampaktsis1, Ajayram V Ullal2, Rajesh V Swaminathan3

  • 1Greenberg Division of Cardiology, Weill Cornell Medical College, New York, New York.

Clinical Cardiology
|August 1, 2018
PubMed

Insights

The absence of electrocardiographic left ventricular hypertrophy (ECG LVH) predicts higher mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Baseline ECG findings are crucial for prognosis and may guide further investigation for myocardial conditions.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Clinical Prognostics

Background:

  • Electrocardiographic left ventricular hypertrophy (ECG LVH) is linked to mortality in asymptomatic aortic stenosis (AS) and hypertension.
  • Symptomatic AS patients undergoing transcatheter aortic valve replacement (TAVR) often exhibit myocardial fibrosis/amyloidosis, correlating with reduced ECG voltage and poorer outcomes.

Purpose of the Study:

  • To investigate if baseline ECG LVH independently predicts all-cause mortality in patients post-TAVR.

Main Methods:

  • Included 231 TAVR patients (mean age 84.7 years).
  • Assessed ECG LVH using Cornell voltage (Sv3 + RaVL) with gender-specific cutoffs.
  • Employed Kaplan-Meier and multivariate Cox regression, adjusting for echocardiographic LVH and mortality predictors.

Main Results:

  • Absence of ECG LVH was significantly associated with increased mortality (40.4% vs 23.6% at 2 years, P=0.003).
  • Even after adjustment for echocardiographic LVH and other predictors, the absence of ECG LVH remained a significant predictor of mortality (HR=1.79, P=0.042).

Conclusions:

  • The absence of baseline ECG LVH is an independent predictor of increased mortality following TAVR.
  • Baseline ECG assessment holds prognostic value in TAVR patients, potentially indicating a need for further evaluation of myocardial fibrosis or amyloidosis.
Abstract

Keywords:
Electrocardiography ambulatory ECGLeft ventricular hypertrophyTranscather aortic valve replacement

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