Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes

Background The clinical significance of the discrepancy between left ventricular hypertrophy (LVH) by echocardiography and ECG remains to be elucidated.Methods After excluding patients who presented with pacemaker placement, QRS duration ≥120 ms and cardiomyopathy and moderate to severe valvular dis...

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Main Authors: Takao Kato, Moriaki Inoko, Yuta Seko, Yuhei Yamaji, Eisaku Nakane, Tetsuya Haruna, Yoshisumi Haruna
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/8/2/e001765.full
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author Takao Kato
Moriaki Inoko
Yuta Seko
Yuhei Yamaji
Eisaku Nakane
Tetsuya Haruna
Yoshisumi Haruna
author_facet Takao Kato
Moriaki Inoko
Yuta Seko
Yuhei Yamaji
Eisaku Nakane
Tetsuya Haruna
Yoshisumi Haruna
author_sort Takao Kato
collection DOAJ
description Background The clinical significance of the discrepancy between left ventricular hypertrophy (LVH) by echocardiography and ECG remains to be elucidated.Methods After excluding patients who presented with pacemaker placement, QRS duration ≥120 ms and cardiomyopathy and moderate to severe valvular disease, we retrospectively analysed 3212 patients who had undergone both scheduled transthoracic echocardiography (echo) and ECG in a hospital-based population. Cornell product >2440 mm · ms was defined as ECG-based LVH; left ventricular mass index >115 g/m2 for men and >95 g/m2 for women was defined as echo-based LVH. The study population was categorised into four groups: patients with both ECG-based and echo-based LVH (N=131, 4.1%), those with only echo-based LVH (N=156, 4.9%), those with only ECG-based LVH (N=409, 12.7%) and those with no LVH (N=2516, 78.3%).Results The cumulative 3-year incidences of a composite of all-cause death and major adverse cardiovascular events were 32.0%, 33.8%, 19.2% and 15.7%, respectively. After adjusting for confounders, the HRs relative to that in no LVH were 1.63 (95% CI 1.16 to 2.28), 1.68 (95% CI 1.23 to 2.30) and 1.09 (95% CI 0.85 to 1.41) in patients with both ECG-based and echo-based LVH, those with only echo-based LVH, and those with only ECG-based LVH, respectively.Conclusions Echo-based LVH without ECG-based LVH was associated with a significant risk of adverse clinical events, and the risk was comparable to that in patients with both echo-based and ECG-based LVH.
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spelling doaj-art-c8b4026f35e2481db3e121a770ab7b512024-11-11T17:40:11ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001765Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomesTakao Kato0Moriaki Inoko1Yuta Seko2Yuhei Yamaji3Eisaku Nakane4Tetsuya Haruna5Yoshisumi Haruna6Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, JapanCardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanDepartment of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, JapanCardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanCardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanCardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanCardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, JapanBackground The clinical significance of the discrepancy between left ventricular hypertrophy (LVH) by echocardiography and ECG remains to be elucidated.Methods After excluding patients who presented with pacemaker placement, QRS duration ≥120 ms and cardiomyopathy and moderate to severe valvular disease, we retrospectively analysed 3212 patients who had undergone both scheduled transthoracic echocardiography (echo) and ECG in a hospital-based population. Cornell product >2440 mm · ms was defined as ECG-based LVH; left ventricular mass index >115 g/m2 for men and >95 g/m2 for women was defined as echo-based LVH. The study population was categorised into four groups: patients with both ECG-based and echo-based LVH (N=131, 4.1%), those with only echo-based LVH (N=156, 4.9%), those with only ECG-based LVH (N=409, 12.7%) and those with no LVH (N=2516, 78.3%).Results The cumulative 3-year incidences of a composite of all-cause death and major adverse cardiovascular events were 32.0%, 33.8%, 19.2% and 15.7%, respectively. After adjusting for confounders, the HRs relative to that in no LVH were 1.63 (95% CI 1.16 to 2.28), 1.68 (95% CI 1.23 to 2.30) and 1.09 (95% CI 0.85 to 1.41) in patients with both ECG-based and echo-based LVH, those with only echo-based LVH, and those with only ECG-based LVH, respectively.Conclusions Echo-based LVH without ECG-based LVH was associated with a significant risk of adverse clinical events, and the risk was comparable to that in patients with both echo-based and ECG-based LVH.https://openheart.bmj.com/content/8/2/e001765.full
spellingShingle Takao Kato
Moriaki Inoko
Yuta Seko
Yuhei Yamaji
Eisaku Nakane
Tetsuya Haruna
Yoshisumi Haruna
Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
Open Heart
title Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
title_full Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
title_fullStr Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
title_full_unstemmed Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
title_short Discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy: clinical characteristics and outcomes
title_sort discrepancy between left ventricular hypertrophy by echocardiography and electrocardiographic hypertrophy clinical characteristics and outcomes
url https://openheart.bmj.com/content/8/2/e001765.full
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