Abstract P231: Electrocardiographic Versus Echocardiographic Left Ventricular Hypertrophy as a Predictor of Cardiovascular Disease Events in the General Population
Introduction: It is uncertain whether left ventricular hypertrophy (LVH) detected by the electrocardiogram (ECG) is able to be used as an alternative to LVH detected by imaging in population studies.
Aim: We compared the risk of cardiovascular disease (CVD) associated with LVH as measured by Minnesota ECG classification (ECG-LVH), the most common ECG classification in population studies, with LVH detected by echocardiography, the most common tool to estimate left ventricular mass in clinical practice.
Methods: This analysis included 4,076 participants (41% male, 86% white), aged 65 years or older from the Cardiovascular Health Study who were free of CVD at the time of enrollment. ECG-LVH was defined by the Minnesota ECG Classification criteria from baseline ECG data that were read centrally. Echocardiographic LVH (echo-LVH) was defined as left ventricular mass >95th percentile using sex-specific cut-points.
Results: ECG-LVH was detected in 144 (3.5%) participants and echo-LVH in 199 (4.9%) participants. Over a mean follow-up of 10.6 years, a total of 2,274 CVD events occurred. In a multivariate Cox regression analysis adjusted for age, sex, race, education, income, body mass index, HDL-cholesterol, total-cholesterol, smoking status, systolic blood pressure, diabetes, aspirin and blood pressure lowering drugs, the risk of CVD events associated with ECG-LVH (HR=1.84, 95% CI=1.51, 2.24) was higher than that associated with echo-LVH (HR=1.35, 95% CI 1.12, 1.62). The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR=1.81, 95% CI=1.49, 2.21).
Conclusion: The association of ECG-LVH with CVD events is not dependent on echo-LVH and provides additional support to the concept that ECG-LVH is an electrophysiologic marker with predictive properties independent of left ventricular anatomy.
Author Disclosures: J.A. Leigh: None. W.T. O’Neal: None. E.Z. Soliman: None.
- © 2016 by American Heart Association, Inc.