AIM:: We assessed the value of three electrocardiographic (ECG) voltage criteria in detecting left ventricular hypertrophy (LVH) and in predicting cardiovascular events and all-cause mortality in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) population. METHODS:: At entry, 1549 individuals (age 50±13 years, 50.5% men) underwent diagnostic tests including laboratory investigations, 24-h ambulatory blood pressure monitoring, and standard ECG and echocardiography. RESULTS:: The sensitivity of ECG criteria for LVH was lowest for Sokolow-Lyon voltage (1.5 and 0.78%), intermediate for Cornell voltage (20.5 and 19.0%), and highest for RaVL wave amplitude (26.0 and 36.2%), independently of whether left ventricular mass was indexed to body surface area or height, respectively. After adjustment for age, sex, night-time SBP, low-density lipoprotein and high-density lipoprotein cholesterol, serum glucose, BMI, smoking, and previous cardiovascular events, only Cornell voltage index [hazard ratio for a 0.1 mV increase: 1.050, 95% confidence interval (CI): 1.017-1.083, P < 0.003] predicted an increased risk of cardiovascular events as well as all-cause mortality. Furthermore, when the categorical relationship between ECG-graphic LVH and cardiovascular outcomes was investigated in multiple models, only LVH identified by the Cornell voltage index remained an independent predictor of cardiovascular events (hazard ratio=2.466, CI 1.459-4.168, P=0.0008) and all-cause deaths (hazard ratio=2.984, CI 1.380-6.449, P=0.005). CONCLUSION:: Despite the limited sensitivity of ECG voltage criteria in detecting LVH, our results show that Cornell voltage index may improve cardiovascular risk stratification in a general population independently of several confounding factors.

Cuspidi, C., Facchetti, R., Bombelli, M., Sala, C., Grassi, G., Mancia, G. (2014). Accuracy and prognostic significance of electrocardiographic markers of left ventricular hypertrophy in a general population: Findings from the Pressioni Arteriose Monitorate e Loro Associazioni population. JOURNAL OF HYPERTENSION, 32(4), 921-928 [10.1097/HJH.0000000000000085].

Accuracy and prognostic significance of electrocardiographic markers of left ventricular hypertrophy in a general population: Findings from the Pressioni Arteriose Monitorate e Loro Associazioni population

CUSPIDI, CESARE
Primo
;
FACCHETTI, RITA LUCIA
Secondo
;
BOMBELLI, MICHELE;GRASSI, GUIDO
Penultimo
;
MANCIA, GIUSEPPE
Ultimo
2014

Abstract

AIM:: We assessed the value of three electrocardiographic (ECG) voltage criteria in detecting left ventricular hypertrophy (LVH) and in predicting cardiovascular events and all-cause mortality in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) population. METHODS:: At entry, 1549 individuals (age 50±13 years, 50.5% men) underwent diagnostic tests including laboratory investigations, 24-h ambulatory blood pressure monitoring, and standard ECG and echocardiography. RESULTS:: The sensitivity of ECG criteria for LVH was lowest for Sokolow-Lyon voltage (1.5 and 0.78%), intermediate for Cornell voltage (20.5 and 19.0%), and highest for RaVL wave amplitude (26.0 and 36.2%), independently of whether left ventricular mass was indexed to body surface area or height, respectively. After adjustment for age, sex, night-time SBP, low-density lipoprotein and high-density lipoprotein cholesterol, serum glucose, BMI, smoking, and previous cardiovascular events, only Cornell voltage index [hazard ratio for a 0.1 mV increase: 1.050, 95% confidence interval (CI): 1.017-1.083, P < 0.003] predicted an increased risk of cardiovascular events as well as all-cause mortality. Furthermore, when the categorical relationship between ECG-graphic LVH and cardiovascular outcomes was investigated in multiple models, only LVH identified by the Cornell voltage index remained an independent predictor of cardiovascular events (hazard ratio=2.466, CI 1.459-4.168, P=0.0008) and all-cause deaths (hazard ratio=2.984, CI 1.380-6.449, P=0.005). CONCLUSION:: Despite the limited sensitivity of ECG voltage criteria in detecting LVH, our results show that Cornell voltage index may improve cardiovascular risk stratification in a general population independently of several confounding factors.
Articolo in rivista - Articolo scientifico
Echocardiography; Electrocardiography; Left ventricular hypertrophy cardiovascular prognosis;
English
2014
32
4
921
928
none
Cuspidi, C., Facchetti, R., Bombelli, M., Sala, C., Grassi, G., Mancia, G. (2014). Accuracy and prognostic significance of electrocardiographic markers of left ventricular hypertrophy in a general population: Findings from the Pressioni Arteriose Monitorate e Loro Associazioni population. JOURNAL OF HYPERTENSION, 32(4), 921-928 [10.1097/HJH.0000000000000085].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/70810
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