Journal of Electrocardiology
Volume 41, Issue 4 , Pages 342-350 , July 2008

Thresholds in the relationship between mortality and left ventricular hypertrophy defined by electrocardiography

  • Edward P. Havranek, MD

      Affiliations

    • Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
    • Corresponding Author InformationCorresponding author. Denver Health Medical Center #0960, Denver, CO 80204-4507, USA. Tel.: +1 303 436 5499; fax: +1 303 436 7739.
  • ,
  • Caroline D.B. Emsermann, MS

      Affiliations

    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • Desiree N. Froshaug, BS

      Affiliations

    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • Frederick A. Masoudi, MD MSPH

      Affiliations

    • Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • Mori J. Krantz, MD

      Affiliations

    • Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • Rebecca Hanratty, MD

      Affiliations

    • Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • Raymond O. Estacio, MD

      Affiliations

    • Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA
    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • L. Miriam Dickinson, PhD

      Affiliations

    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
  • ,
  • John F. Steiner, MD, MPH

      Affiliations

    • Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA

Received 13 February 2007 ,Accepted 15 November 2007.

References 

  1. Levy D, Garrison RJ, Savage DD, Kannel WB, Casatelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561
  2. Brown DW, Giles WH, Croft JB. Left ventricular hypertrophy as a predictor of coronary heart disease mortality and the effect of hypertension. Am Heart J. 2000;140:848
  3. Devereux RB, Wachtell K, Gerdts E, et al. Prognostic significance of left ventricular mass change during treatment of hypertension. JAMA. 2004;292:2350
  4. Matthew J, Sleight P, Lonn E, et al. for the Heart Outcomes Prevention Evaluation (HOPE) Investigators Reduction of cardiovascular risk by regression of electrocardiographic markers of left ventricular hypertrophy by the angiotensin-converting enzyme inhibitor ramipril. Circulation. 2001;104:1615
  5. Havranek EP, Esler A, Mehler PS, Estacio RO, Schrier RW. Differential effects of anti-hypertensive agents on ECG voltage: results from the Appropriate Blood Pressure Control in Diabetes (ABCD) Trial. Am Heart J. 2003;145:993
  6. Rautaharju PM, Manolio TA, Siscovick D, et al. for the Cardiovascular Health Study Collaborative Research Group Utility of new electrocardiographic models for left ventricular mass in older adults. Hypertension. 1996;28:8
  7. http://www.cdc.gov/nchs/nhanes.htm. Accessed June 1, 2007.
  8. http://www.cdc.gov/nchs/r&d/nchs_datalinkage/nhanes_data_linkage_activities.htm. Accessed June 1, 2007.
  9. http://www.cdc.gov/nchs/ndi.htm. Accessed June 1, 2007.
  10. Casale PN, Devereux RB, Kligfield P, et al. Electrocardiographic detection of left ventricular hypertrophy: development and prospective validation of improved criteria. J Am Coll Cardiol. 1985;6:572
  11. Molloy TJ, Okin PM, Devereux RB, Kligfield P. ECG detection of echocardiographic left ventricular hypertrophy by the simple QRS voltage-duration product. J Am Coll Cardiol. 1992;20:1180
  12. Norman JE, Levy D. Improved electrocardiographic detection of echocardiographic left ventricular hypertrophy: results of a correlated data base approach. J Am Coll Cardiol. 1995;26:1022
  13. Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949;37:161
  14. Rautaharju PM, Lacroix AZ, Savage DD, et al. Electrocardiographic estimate of left ventricular mass versus radiographic cardiac size and the risk of cardiovascular disease mortality in the epidemiologic Follow-Up Study of the First National Health and Nutrition Examination Survey. Am J Cardiol. 1988;62:59
  15. Available at http://www.cdc.gov/nchs/about/major/nhanes/nh3data.htm#Data%20Files%202a. Accessed June 1, 2007.
  16. Okin PM, Devereux RB, Nieminen MS, et al. for the LIFE Study Investigators Relationship of the electrocardiographic strain pattern to left ventricular structure and function in hypertensive patients: The LIFE Study. J Am Coll Cardiol. 2001;38:514
  17. Anderson KM, Wilson PWF, Odell PM, Kannel WB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83:357
  18. Prineas RJ, Rautaharju PM, Grandits G, Crow R for the MRFIT Research Group. Independent risk for cardiovascular disease predicted by modified continuous score ECG criteria for 6-year incidence and regression of left ventricular hypertrophy among clinically disease free men: 16-year follow-up for the Multiple Risk Factor Intervention Trial. J Electrocardiol. 2001;34:91
  19. Okin PM, Roman MJ, Devereux RB, Kligfield P. Electrocardiographic identification of left ventricular hypertrophy: test performance in relation to definition of hypertrophy and presence of obesity. J Am Coll Cardiol. 1996;27:124
  20. Verdecchia P, Schillaci G, Borgioni C, et al. Prognostic value of a new electrocardiographic method for diagnosis of left ventricular hypertrophy. J Am Coll Cardiol. 1998;31:383
  21. Devereux RB, Lutas EM, Casale PN, et al. Standardization of M-mode echocardiographic left ventricular anatomic measurements. J Am Coll Cardiol. 1984;1222
  22. Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelli WP. Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol. 1987;59:956
  23. Liao Y, Cooper RS, Mensah GA, McGee DL. Left ventricular hypertrophy has a greater impact on survival in women than in men. Circulation. 1995;92:805
  24. Casale PN, Devereux RB, Kligfield P, et al. ECG detection of left ventricular hypertrophy: development and prospective validation of improved criteria. J Am Coll Cardiol. 1985;6:572
  25. Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P. Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings. Circulation. 1987;75:565
  26. Vijan SG, Manning G, Millar-Craig MW. How reliable is the electrocardiogram in detecting left ventricular hypertrophy in hypertension?. Postgrad Med J. 1991;67:646
  27. Abergel E, Tase M, Menard J, Chatellier G. Influence of obesity on the diagnostic value of ECG criteria for detecting left ventricular hypertrophy. Am J Cardiol. 1996;77:739
  28. Okin PM, Jern S, Devereux RB, Kjeldsen SE, Dahlof B for the LIFE Study Group. Effect of obesity on electrocardiographic left ventricular hypertrophy in hypertensive patients: The Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study. Hypertension. 2000;35:13
  29. Velury S, Spodick DH. Increased left ventricular mass in patients with lateral low-voltage electrocardiograms. Am J Cardiol. 1992;69:707
  30. Levy D, Salomon M, D'Agostino RB, Belanger AJ, Kannel WB. Prognostic implications of baseline ECG features and their serial changes in subjects with left ventricular hypertrophy. Circulation. 1994;90:1786
  31. Fagard RH, Staessen JA, Thijs L, et al. for the Systolic Hypertension in Europe (Syst-Eur) Trial Investigators Prognostic significance of electrocardiographic voltages and their serial changes in elderly with systolic hypertension. Hypertension. 2004;44:459
  32. Okin PM, Devereux RB, Jern S, et al. for the LIFE Study Investigators Regression of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of major cardiovascular events. JAMA. 2004;292:2343
  33. Lee DK, Marantz PR, Devereux RB, Kligfield P, Alderman MH. Left ventricular hypertrophy in black and white hypertensives. Standard ECG criteria overestimate racial differences in prevalence. JAMA. 1992;267:3294
  34. Arnett DK, Rautaharju P, Crow R, et al. the ARIC Investigators Black-white differences in ECG left ventricular mass and its association with blood pressure (the ARIC Study). Am J Cardiol. 1994;74:247
  35. Rautaharju PM, Park LP, Gottdiener JS, et al. Race- and sex-specific ECG models for left ventricular mass in older populations. Factors influencing overestimation of left ventricular hypertrophy prevalence by ECG criteria in African-Americans. J Electrocardiol. 2000;33:205
  36. Okin PM, Wright JT, Nieminen MS, et al. for the LIFE Study Investigators Ethnic differences in electrocardiographic criteria for left ventricular hypertrophy: the LIFE Study. Am J Hypertens. 2002;15:663

 National Heart, Lung, and Blood Institute grant U01 HL079160 (Bethesda, Maryland, USA) and Health Resources and Services Administration Administrative Unit grant HP00054 5 D12 (Rockville, Maryland, USA).

PII: S0022-0736(07)00923-5

doi: 10.1016/j.jelectrocard.2007.11.006

Journal of Electrocardiology
Volume 41, Issue 4 , Pages 342-350 , July 2008