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Left ventricular hypertrophy: effect on survival
J M Sullivan1, R V Vander Zwaag, F el-Zeky
1Division of Cardiovascular Disease, University of Tennessee, Memphis 38163.
Insights
Left ventricular hypertrophy (LVH) independently reduces survival, even without coronary artery disease. This finding highlights LVH as a critical factor impacting patient outcomes and mortality risk.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for coronary heart disease mortality.
- The independent impact of LVH on survival, especially when coexisting with coronary artery stenosis, requires clarification.
Purpose of the Study:
- To determine if left ventricular hypertrophy (LVH) has an independent adverse effect on patient survival.
- To investigate the relationship between electrocardiographic (ECG) LVH, coronary artery disease, and long-term survival outcomes.
Main Methods:
- Analysis of 4,824 patients who underwent coronary arteriography between 1972 and 1985.
- Exclusion of patients who had undergone revascularization or had unstable angina, specific heart conditions, or non-LVH ECG changes.
- Examination of the association between ECG-defined LVH, ST-T segment abnormalities, coronary artery disease, and five-year survival rates.
Main Results:
- Five-year survival was significantly lower in patients with LVH (81.9%) compared to those without (90.2%).
- LVH adversely affected survival irrespective of coronary artery disease presence (84.4% vs 94.5% without CAD; 81.0% vs 87.7% with CAD).
- ST segment abnormalities did not significantly reduce survival in patients without coronary disease.
Conclusions:
- Electrocardiographic left ventricular hypertrophy (LVH) adversely impacts survival.
- The adverse effect of LVH on survival is independent of the presence of coronary artery disease.
- LVH is a significant prognostic indicator for mortality in cardiac patients.
Objectives:
The aim of the study was to determine whether left ventricular hypertrophy has an independent adverse effect on survival.
Background:
Left ventricular hypertrophy is considered to be a significant risk factor for coronary heart disease mortality; however, the impact of coexisting coronary artery stenosis on survival statistics is not clear.
Methods:
The relations among electrocardiographic (ECG) left ventricular hypertrophy, ST-T segment abnormality, coronary artery disease and survival were examined in 18,969 patients undergoing coronary arteriography between 1972 and 1985. Patients were excluded if they underwent coronary revascularization or had unstable angina, rheumatic or congenital heart disease, cardiomyopathy, pericardial disease or ECG changes other than left ventricular hypertrophy or repolarization abnormalities, leaving 4,824 patients for analysis.
Results:
Left ventricular hypertrophy was present in 249 patients, whereas 4,575 were free of left ventricular hypertrophy. Five-year survival was 90.2% in the group without left ventricular hypertrophy and was significantly lower (81.9%, p < 0.001) in the group with left ventricular hypertrophy. Five-year survival was significantly lower in patients with left ventricular hypertrophy, regardless of whether coronary artery disease was present: 84.4% versus 94.5% (p = 0.016) in the absence of coronary artery disease and 81.0% versus 87.7% (p < 0.001) in the presence of coronary artery disease. The presence of ST segment abnormalities was not associated with a significant reduction in survival in patients without coronary disease, although mortality was less in those without ST changes who had coronary disease (p = 0.012).
Conclusions:
It is concluded that ECG left ventricular hypertrophy has an adverse effect on survival, even in patients who are free of coronary artery disease.