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Yang P, Ge Z, Gao J, Liu X, Xu M, Ke H. Evaluation of the electrocardiogram RV 5 /V 6 criteria in the diagnosis of left ventricular hypertrophy in marathon runners. J Clin Hypertens (Greenwich) 2023. [PMID: 37378534 DOI: 10.1111/jch.14692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
To assess the value of electrocardiogram (ECG) RV5/V6 criteria for diagnosing left ventricular hypertrophy (LVH) in marathons. A total of 112 marathon runners who met the requirements for "Class A1" events certified by the Chinese Athletics Association in Changzhou City were selected, and their general clinical information was collected. ECG examinations were performed using a Fukuda FX7402 Cardimax Comprehensive Electrocardiograph Automatic Analyser, whereas routine cardiac ultrasound examinations were performed using a Philips EPIQ 7C echocardiography system. Real-time 3-dimensional echocardiography (RT-3DE) was performed to acquire 3-dimensional images of the left ventricle and to calculate the left ventricular mass index (LVMI). According to the LVMI criteria of the American Society of Echocardiography for the diagnosis of LVH, the participants were divided into an LVMI normal group (n = 96) and an LVH group (n = 16). The correlation between the ECG RV5/V6 criteria and LVH in marathon runners was analysed using multiple linear regression stratified by sex and compared with the Cornell (SV3 + RaVL), modified Cornell (SD + RaVL), Sokolow-Lyon (SV1 + RV5/V6), Peguero-Lo Presti (SD + SV4), SV1, SV3, SV4, and SD criteria. In marathon runners, the ECG parameters SV3 + RaVL, SD + RaVL, SV1 + RV5/V6, SD + SV4, SV3, SD, and RV5/V6 were able to identify LVH (all p < .05). When stratified by sex, linear regression analysis revealed that a significantly higher number of ECG RV5/V6 criteria were evident in the LVH group than in the LVMI normal group (p < .05), both with no adjustment and after initial adjustment (including age and body mass index), as well as after full adjustment (including age, body mass index, interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular posterior wall thickness, and history of hypertension). Additionally, curve fitting showed that the ECG RV5/V6 values increased with increasing LVMI in marathon runners, exhibiting a nearly linear positive correlation. In conclusions, the ECG RV5/V6 criteria were correlated with LVH in marathon runners.
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Affiliation(s)
- Pan Yang
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
| | - Zhixiang Ge
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
| | - Jinmei Gao
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
| | - Xia Liu
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
| | - Min Xu
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
| | - Haiyan Ke
- Department of Cardiovascular Division of The Third Affiliated Hospital of Soochow University, Chang Zhou NO.1 Hospital, Chang Zhou City, Jiangsu Province, China
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Rankinen J, Haataja P, Lyytikäinen LP, Huhtala H, Lehtimäki T, Kähönen M, Eskola M, Tuohinen S, Pérez-Riera AR, Jula A, Rissanen H, Nikus K, Hernesniemi J. Prevalence and long-term prognostic implications of prolonged QRS duration in left ventricular hypertrophy: a population-based observational cohort study. BMJ Open 2022; 12:e053477. [PMID: 35228283 PMCID: PMC8886432 DOI: 10.1136/bmjopen-2021-053477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES ECG left ventricular hypertrophy (ECG-LVH) has been associated with left ventricular dysfunction and adverse prognosis, but little is known about the prevalence and prognostic significance of different levels of QRS duration in the presence of ECG-LVH in a general population. DESIGN Population-based observational prospective cohort study. PARTICIPANTS Nationally representative random cluster of Finnish adult population. METHODS We assessed the prevalence and long-term (median 15.9 years) prognostic significance of QRS duration in ECG-LVH, and compared the risk to individuals without ECG-LVH in a predominantly middle-aged random sample of 6033 Finnish subjects aged over 30 years (mean age 52.2, SD 14.6 years), who participated in a health examination including a 12-lead ECG. MAIN OUTCOME MEASURES Cardiovascular and all-cause mortality, incidence of heart failure (HF). RESULTS ECG-LVH was present in 1337 (22.2%) subjects; 403 of these (30.1%) had QRS duration ≥100 ms and 100 (7.5%) had ≥110 ms. The increased risk of mortality in ECG-LVH became evident after a QRS threshold of ≥100 ms. After controlling for known clinical risk factors, QRS 100-109 ms was associated with increased cardiovascular (HR 1.38, 95% CI 1.01 to 1.88, p=0.045) and QRS≥110 ms with cardiovascular (1.74, 95% CI 1.07 to 2.82, p=0.025) and all-cause mortality (1.52, 95% CI 1.02 to 2.25, p=0.039) in ECG-LVH. The risk of new-onset HF was two-fold in subjects with QRS 100-109 ms and threefold in subjects with QRS ≥110 ms, even after adjustment for incident myocardial infarction within the follow-up. When the prognosis was compared with subjects without ECG-LVH, subjects with ECG-LVH but QRS duration <100 ms displayed similar mortality rates with or without ECG-LVH but higher rates of incident HF. CONCLUSIONS In ECG-LVH, the risk of excess mortality and new-onset HF markedly increases with longer QRS duration, but even QRS duration within normal limits in ECG-LVH carried a risk of HF compared with the risk in individuals without ECG-LVH.
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Affiliation(s)
- Jani Rankinen
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Department of Internal Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Petri Haataja
- Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland
| | - Leo-Pekka Lyytikäinen
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland
- Department of Clinical Chemistry, Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Department of Clinical Chemistry, Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Markku Eskola
- Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland
| | - Suvi Tuohinen
- Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Andrés Ricardo Pérez-Riera
- Design of Studies and Scientific Writing Laboratory, Faculdade de Medicina do ABC, Santo Andre, São Paulo, Brazil
| | - Antti Jula
- Finnish Institute for Health and Welfare, Helsinki/Turku, Finland
| | - Harri Rissanen
- Finnish Institute for Health and Welfare, Helsinki/Turku, Finland
| | - Kjell Nikus
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland
| | - Jussi Hernesniemi
- Faculty of Medicine and Health Technology, Tampere University, and Finnish Cardiovascular Research Center, Tampere, Finland
- Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland
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Zaproudina N, Niiranen TJ, Anttila V, Kallela M. Left ventricular hypertrophy and other cardiac risk factors in migraineurs. Acta Neurol Scand 2021; 143:661-665. [PMID: 33733453 DOI: 10.1111/ane.13410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The influence of cardiovascular risk factors on the probability of cardiovascular diseases in migraineurs is still being discussed. AIMS OF THE STUDY To further elucidate the mechanisms of these relationships, we assessed the associations between migraine and cardiovascular risk factors, including those that have been recently shown to improve the prediction of cardiovascular events. METHODS We used the data of the Finnish Health 2000 Survey (BRIF8901), consisting of 5737 subjects aged 30 years or older. In total, 488 participants reported migraine. In addition to conventional cardiovascular risk factors, educational attainment, presence of electrocardiographic signs of left ventricular hypertrophy and hemoglobin A1c were also included in the logistic regression analyses. RESULTS Migraine was found to be associated with female sex (Odds ratio (OR) = 3.75, p < .001), lower age (B = 0.99, p < .001), lower high-density lipoprotein cholesterol (OR = 1.23, p < .05), higher diastolic blood pressure (OR = 1.31, p < .05), and left ventricular hypertrophy (OR = 1.32, p < .05), the probability of the last one increasing with migraine attack frequency. CONCLUSIONS Left ventricular hypertrophy, most probably as a consequence of migraine-related arterial hypertension and dyslipidemia, may play a role in the relationship between migraine and cardiovascular events. The nature of this finding calls for further studies.
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Affiliation(s)
- Nina Zaproudina
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland
| | - Teemu J. Niiranen
- Department of Medicine Turku University Hospital and University of Turku Turku Finland
- Department of Public Health Solutions National Institute for Health and Welfare Turku Finland
| | - Verneri Anttila
- Analytical and Translational Genetics Unit Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Program in Medical and Population Genetics Broad Institute of MIT and Harvard Cambridge MA USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge MA USA
| | - Mikko Kallela
- Department of Neurology Helsinki University and Helsinki University Hospital Helsinki Finland
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The Groningen electrocardiographic criteria for left ventricular hypertrophy: a sex-specific analysis. Sci Rep 2021; 11:6662. [PMID: 33758211 PMCID: PMC7988153 DOI: 10.1038/s41598-021-83137-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/09/2020] [Indexed: 11/09/2022] Open
Abstract
The sensitivity of electrocardiogram (ECG) criteria to detect left ventricular hypertrophy (LVH) is low, especially in women. We determined sex-specific sensitivities of ECG-LVH criteria, and developed new criteria, using cardiovascular magnetic resonance imaging (CMR). Sensitivities of ECG-LVH criteria were determined in participants of the UK Biobank (N = 3632). LVH was defined when left ventricular mass was > 95% confidence interval (CI) according to age and sex. In a training cohort (75%, N = 2724), sex-specific ECG-LVH criteria were developed by investigating all possible sums of QRS-amplitudes in all 12 leads, and selecting the sum with the highest pseudo-R2 and area under the curve to detect LVH. Performance was assessed in a validation cohort (25%, N = 908), and association with blood pressure change was investigated in an independent cohort. Sensitivities of ECG-LVH criteria were low, especially in women. Newly developed Groningen-LVH criterion for women (QV2 + RI + RV5 + RV6 + SV2 + SV4 + SV5 + SV6) outperformed all ECG-LVH criteria with a sensitivity of 42% (95% CI 35-49%). In men, newly developed criterion ((RI + RV5 + SII + SV2 + SV6) × QRS duration) was equally sensitive as 12-lead sum with a sensitivity of 44% (95% CI 37-51%) and outperformed the other criteria. In an independent cohort, the Groningen-LVH criteria were strongest associated with change in systolic blood pressure. Our proposed CMR sex-specific Groningen-LVH criteria improve the sensitivity to detect LVH, especially in women. Further validation and its association with clinical outcomes is warranted.
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You Z, He T, Ding Y, Yang L, Jiang X, Huang L. Predictive value of electrocardiographic left ventricular hypertrophy in the general population: A meta-analysis. J Electrocardiol 2020; 62:14-19. [PMID: 32745730 DOI: 10.1016/j.jelectrocard.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Conflicting results have been reported on the predictive value of the electrocardiographic left ventricular hypertrophy (LVH) in the general population. This meta-analysis sought to compare the predictive value of different electrocardiographic criteria of LVH in the general population. METHODS We comprehensively searched PubMed and Embase databases until May 9, 2020 to identify observational studies investigating the predictive value of different electrocardiographic criteria for LVH (Sokolow-Lyon voltage, Cornell voltage or Cornell product) in the general population. Outcome measures were major adverse cardiovascular events (MACEs), cardiovascular or all-cause mortality. RESULTS Ten studies enrolling 58,400 individuals were included. Comparison with and without electrocardiographic LVH, the pooled risk ratio (RR) of MACEs was 1.62 (95% confidence interval [CI] 1.40-1.89) for the Sokolow-Lyon voltage criteria, 1.70 (95% CI 1.27-2.29) for the Cornell voltage criteria, and 1.56 (95% CI 1.17-2) for the Cornell product criteria. The pooled RR of all-cause mortality was 1.47 (95% CI 1.10-1.97) for the Sokolow-Lyon voltage criteria and 1.87 (95% CI 1.29-2.71) for the Cornell voltage criteria. Furthermore, the pooled RR of cardiovascular mortality was 1.38 (95% CI 1.19-1.60) for the Sokolow-Lyon criteria, 1.66 (95% CI 1.24-2.33) for the Cornell voltage criteria, and 1.82 (95% CI 0.65-5.09) for the Cornell product criteria. CONCLUSIONS Different electrocardiographic criteria for evaluating LVH had a similar value in predicting MACEs among the general population. LVH detected by the Cornell voltage appeared to have a stronger predictive value in prediction of cardiovascular or all-cause mortality.
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Affiliation(s)
- Zhigang You
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China
| | - Ting He
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China
| | - Ying Ding
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China
| | - Lu Yang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China
| | - Xinghua Jiang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China
| | - Lin Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, 330006, China.
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Xu M, Ge Z, Huang J, Shao X, Li J, Mrcp, Yang J. Modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy geometry of patients with essential hypertension. J Clin Hypertens (Greenwich) 2020; 22:1239-1246. [PMID: 32639109 PMCID: PMC7497263 DOI: 10.1111/jch.13919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/24/2020] [Accepted: 06/07/2020] [Indexed: 01/10/2023]
Abstract
To evaluate the value of modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy (LVH) for patients with essential hypertension. A total of 381 patients with essential hypertension diagnosed in our hospital were selected. Using the left ventricle (LV) geometric patterns classified by the American Society of Echocardiography (ASE), we examined the distribution of the modified Cornell criteria of Ravl + SD (the deepest S wave in 12‐lead ECG) in different geometric patterns and analyzed the correlation of modified Cornell criteria with changes in the LV geometric patterns using multiple linear regression analysis. The distribution of modified Cornell criteria, Sokolow‐Lyon criteria (RV5/V6 + SV1), and Cornell criteria (Ravl + SV3) in gender‐specific hypertensive geometric patterns were significantly different (P ≤ .01 for all). The voltage of Ravl + SD in male patients showed an increase trend in the normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups, and this increase trend was significantly in the unadjusted model and the adjusted model. The voltages of Ravl + SV3 and RV5/V6 + SV1 of male patients in CR, CH and RH groups showed a gradual increase trend, but the increase trend in CR group has no statistical significance compared to that in NG group (P ≥ .05). The voltages of Ravl + SD, RV5/V6 + SV1, and Ravl + SV3 in female patients in CR, CH and EH groups showed a trend of increase after decrease in the adjusted model. In conclusion, the modified Cornell criteria could dynamically reflect left ventricular hypertensive geometry of male patients.
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Affiliation(s)
- Min Xu
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou, China.,Department of Echocardiography of The First Affiliated Hospital of Soochow University, Su Zhou, China
| | - Zhixiang Ge
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | - Jun Huang
- Department of Echocardiography of The Affiliated Hospital of Nanjing Medical University, Chang Zhou, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | | | - Mrcp
- Department of General Surgery of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | - Junhua Yang
- Department of Echocardiography of The First Affiliated Hospital of Soochow University, Su Zhou, China
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Sánez Tähtisalo H, Hiltunen TP, Kenttä T, Junttila J, Oikarinen L, Virolainen J, Kontula KK, Porthan K. Effect of four classes of antihypertensive drugs on cardiac repolarization heterogeneity: A double-blind rotational study. PLoS One 2020; 15:e0230655. [PMID: 32208439 PMCID: PMC7092984 DOI: 10.1371/journal.pone.0230655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/04/2020] [Indexed: 11/21/2022] Open
Abstract
Background T-wave area dispersion (TW-Ad) is a novel electrocardiographic (ECG) repolarization marker associated with sudden cardiac death. However, limited data is available on the clinical correlates of TW-Ad. In addition, there are no previous studies on cardiovascular drug effects on TW-Ad. In this study, we examined the relation between TW-Ad and left ventricular mass. We also studied the effects of four commonly used antihypertensive drugs on TW-Ad. Methods A total of 242 moderately hypertensive males (age, 51±6 years; office systolic/diastolic blood pressure during placebo, 153±14/100±8 mmHg), participating in the GENRES study, were included. Left ventricular mass index was determined by transthoracic echocardiography. Antihypertensive four-week monotherapies (a diuretic, a beta-blocker, a calcium channel blocker, and an angiotensin receptor antagonist) were administered in a randomized rotational fashion. Four-week placebo periods preceded all monotherapies. The average value of measurements (over 1700 ECGs in total) from all available placebo periods served as a reference to which measurements during each drug period were compared. Results Lower, i.e. risk-associated TW-Ad values correlated with a higher left ventricular mass index (r = −0.14, p = 0.03). Bisoprolol, a beta-blocker, elicited a positive change in TW-Ad (p = 1.9×10−5), but the three other drugs had no significant effect on TW-Ad. Conclusions Our results show that TW-Ad is correlated with left ventricular mass and can be modified favorably by the use of bisoprolol, although demonstration of any effects on clinical endpoints requires long-term prospective studies. Altogether, our results suggest that TW-Ad is an ECG repolarization measure of left ventricular arrhythmogenic substrate.
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Affiliation(s)
- Heini Sánez Tähtisalo
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Timo P. Hiltunen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Tuomas Kenttä
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juhani Junttila
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Lasse Oikarinen
- Division of Cardiology, Heart and Lung Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Virolainen
- Division of Cardiology, Heart and Lung Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Kimmo K. Kontula
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kimmo Porthan
- Division of Cardiology, Heart and Lung Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Medicine, University of Helsinki and Minerva Foundation Institute for Medical Research, Helsinki, Finland
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Porthan K, Kenttä T, Niiranen TJ, Nieminen MS, Oikarinen L, Viitasalo M, Hernesniemi J, Jula AM, Salomaa V, Huikuri HV, Albert CM, Tikkanen JT. ECG left ventricular hypertrophy as a risk predictor of sudden cardiac death. Int J Cardiol 2019; 276:125-129. [DOI: 10.1016/j.ijcard.2018.09.104] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022]
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Zhao Y, Huang X, Zhang PP, Bao H, Yu Y, Zhao M, Gu R, Li W, Wang J, Xu QF, Fan F, Li J, Zhang Y, Wang Y, Tang G, Cai Y, Dong Q, Yin D, Cheng X, He M, Wang B, Qin X, Huo Y, Li YG. Electrocardiographic-left ventricular hypertrophy and incident stroke among Chinese hypertensive adults. J Hum Hypertens 2019; 34:286-292. [DOI: 10.1038/s41371-018-0155-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/21/2018] [Accepted: 12/06/2018] [Indexed: 12/30/2022]
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Wang Z, Zhang C, Bao H, Huang X, Fan F, Zhao Y, Li J, Chen J, Hong K, Li P, Wu Y, Wu Q, Wang B, Xu X, Li Y, Huo Y, Cheng X. Value of electrocardiographic left ventricular hypertrophy as a predictor of poor blood pressure control: Evidence from the China stroke primary prevention trial. Medicine (Baltimore) 2018; 97:e12966. [PMID: 30383646 PMCID: PMC6221643 DOI: 10.1097/md.0000000000012966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Recent studies have shown that hypertension is poorly controlled in many populations worldwide. Electrocardiographic left ventricular hypertrophy is a common manifestation of preclinical cardiovascular disease that strongly predicts cardiovascular disease morbidity and mortality. However, little information is available regarding the role of left ventricular hypertrophy in blood pressure (BP) control. We aimed to assess the relationship between electrocardiographic left ventricular hypertrophy and BP control in the China Stroke Primary Prevention Trial. The study population included 17,312 hypertensive patients who were selected from a group of 20,702 adults who had participated in the China Stroke Primary Prevention Trial and had undergone electrocardiography at baseline visit. Multivariate analysis identified left ventricular hypertrophy as a predictor of unsatisfactory BP control. The results revealed that 8.1% of hypertensive adults exhibit left ventricular hypertrophy and that the disease is more prevalent in males (12.8%) than in females. Multivariate regression analysis showed that the electrocardiographic left ventricular hypertrophy group had a significantly higher rate of unsatisfactory BP control [odds ratio (OR) 1.42, 95% confidence interval (95% CI) 1.26-1.61, P < .001) than the nonleft ventricular hypertrophy group.Notable differences in BP control were also observed among males (OR 1.37, 95% CI 1.17-1.60, P < .001) and females (OR 1.45, 95% CI 1.18-1.77, P < .001) and especially among patients with comorbid diabetes (OR 2.32, 95% CI 1.31-4.12, P = .004). In conclusion, the results of this study indicate that electrocardiographic left ventricular hypertrophy appears to be an independent predictive factor for poor BP control, especially in females and patients with comorbid diabetes.
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Affiliation(s)
- Zhenzhen Wang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Chunyan Zhang
- Department of Neurology, the Second Hospital, Shanxi Medical University, Shanxi
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Xiao Huang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Yan Zhao
- Department of Cardiovascular Medicine, XinHua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Juxiang Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Jing Chen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Kui Hong
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Ping Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Yanqing Wu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Qinghua Wu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiping Xu
- National Clinical Research Study Center for Kidney Disease; State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yigang Li
- Department of Cardiovascular Medicine, XinHua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang
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Tanaka K, Tanaka F, Onoda T, Tanno K, Ohsawa M, Sakata K, Omama S, Ogasawara K, Ishibashi Y, Itai K, Kuribayashi T, Okayama A, Nakamura M. Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy on Cardiovascular Risk in a Non-Hypertensive Community-Based Population. Am J Hypertens 2018; 31:895-901. [PMID: 29659657 DOI: 10.1093/ajh/hpy055] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/05/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The appearance of left ventricular hypertrophy on 12-lead electrocardiography (ECG-LVH) has been clarified to be associated with the risk of incidence of cardiovascular events (CVEs) in hypertensive individuals and the general population, but not enough in non-hypertensive individuals. METHODS A total of 4,927 non-hypertensive individuals ≥40 years of age who were free of CVE in the general population were followed for the incidence of CVE. ECG-LVH was defined according to criteria of the Sokolow-Lyon (SL) voltage, Cornell voltage (CV), or Cornell voltage product (CP). RESULTS During the average 9.8 ± 2.0 years of follow-up, 267 individuals (5.4%) had their first CVE. The hazard ratio (HR) for the incidence of CVE after full adjustment by potential confounders significantly increased in the individuals with ECG-LVH by any criteria of the SL voltage, CV, and CP (HR = 1.77, P < 0.001) compared to those with no ECG-LVH. This association was also significant in individuals without any of obesity, dyslipidemia, and diabetes mellitus or those with systolic blood pressure (BP) <120 mm Hg and diastolic BP <80 mm Hg. Furthermore, ECG-LVH by each criteria provided the reclassification improvement for the CVE risk prediction model by the Framingham 10-year risk score (the net reclassification improvement = 0.17-0.22, each P value < 0.010). CONCLUSIONS In the absence of hypertension, ECG-LVH parameters are associated with the increased risk of developed CVEs independent of the established risk factors and provide the additional prognostic value in an assessment of the CVE risk using the traditional risk factors.
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Affiliation(s)
- Kentaro Tanaka
- Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Fumitaka Tanaka
- Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Toshiyuki Onoda
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Masaki Ohsawa
- Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Omama
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | | | - Kazuyoshi Itai
- Department of Nutritional Sciences, Morioka University, Takizawa, Japan
| | - Toru Kuribayashi
- Department of Health and Physical Education, Faculty of Education, Iwate University, Morioka, Japan
| | - Akira Okayama
- The Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Motoyuki Nakamura
- Department of Internal Medicine, Iwate Medical University, Morioka, Japan
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12
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Brinkley TE, Anderson A, Soliman EZ, Bertoni AG, Greenway F, Knowler WC, Glasser SP, Horton ES, Espeland MA. Long-Term Effects of an Intensive Lifestyle Intervention on Electrocardiographic Criteria for Left Ventricular Hypertrophy: The Look AHEAD Trial. Am J Hypertens 2018; 31:541-548. [PMID: 29324968 DOI: 10.1093/ajh/hpy004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/08/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Left ventricular hypertrophy assessed by electrocardiography (ECG-LVH) is a marker of subclinical cardiac damage and a strong predictor of cardiovascular disease (CVD) events. The prevalence of ECG-LVH is increased in obesity and type 2 diabetes; however, there are no data on the long-term effects of weight loss on ECG-LVH. The purpose of this study was to determine whether an intensive lifestyle intervention (ILI) reduces ECG-LVH in overweight and obese adults with type 2 diabetes. METHODS Data from 4,790 Look AHEAD participants (mean age: 58.8 ± 6.8 years, 63.2% White) who were randomized to a 10-year ILI (n = 2,406) or diabetes support and education (DSE, n = 2,384) were included. ECG-LVH defined by Cornell voltage criteria was assessed every 2 years. Longitudinal logistic regression analysis with generalized estimation equations and linear mixed models were used to compare the prevalence of ECG-LVH and changes in absolute Cornell voltage over time between intervention groups, with tests of interactions by sex, race/ethnicity, and baseline CVD status. RESULTS The prevalence of ECG-LVH at baseline was 5.2% in the DSE group and 5.0% in the ILI group (P = 0.74). Over a median 9.5 years of follow-up, prevalent ECG-LVH increased similarly in both groups (odds ratio: 1.02, 95% confidence interval: 0.83-1.25; group × time interaction, P = 0.49). Increases in Cornell voltage during follow-up were also similar between intervention groups (group × time interaction, P = 0.57). Intervention effects were generally similar between subgroups of interest. CONCLUSIONS The Look AHEAD long-term lifestyle intervention does not significantly lower ECG-LVH in overweight and obese adults with type 2 diabetes. CLINICAL TRIALS REGISTRATION Trial Number NCT00017953 (ClinicalTrials.gov).
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Affiliation(s)
- Tina E Brinkley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Andrea Anderson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Elsayed Z Soliman
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Frank Greenway
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
| | - Stephen P Glasser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Edward S Horton
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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13
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Causal Pathways from Blood Pressure to Larger Qrs Amplitudes a Mendelian Randomization Study. Sci Rep 2018; 8:5817. [PMID: 29643338 PMCID: PMC5895613 DOI: 10.1038/s41598-018-24002-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 03/14/2018] [Indexed: 12/29/2022] Open
Abstract
Abnormal QRS duration and amplitudes on the electrocardiogram are indicative of cardiac pathology and are associated with adverse outcomes. The causal nature of these associations remains uncertain and could be due to QRS abnormalities being a symptom of cardiac damage rather than a factor on the causal pathway. By performing Mendelian randomization (MR) analyses using summary statistics of genome wide association study consortia with sample sizes between 20,687 and 339,224 individuals, we aimed to determine which cardiovascular risk factors causally lead to changes in QRS duration and amplitude (Sokolow-Lyon, Cornell and 12-leadsum products). Additionally, we aimed to determine whether QRS traits have a causal relationship with mortality and longevity. We performed inverse-variance weighted MR as main analyses and MR-Egger regression and weighted median estimation as sensitivity analyses. We found evidence for a causal relationship between higher blood pressure and larger QRS amplitudes (systolic blood pressure on Cornell: 55SNPs, causal effect estimate per 1 mmHg = 9.77 millimeters·milliseconds (SE = 1.38,P = 1.20 × 10−12) and diastolic blood pressure on Cornell: 57SNPs, causal effect estimate per 1 mmHg = 14.89 millimeters·milliseconds (SE = 1.82,P = 3.08 × 10−16), but not QRS duration. Genetically predicted QRS traits were not associated with longevity, suggesting a more prominent role of acquired factors in explaining the well-known link between QRS abnormalities and outcome.
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14
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Kim NH, Shin MH, Kweon SS, Ko JS, Lee YH. Carotid Atherosclerosis and Electrocardiographic Left Ventricular Hypertrophy in the General Population: The Namwon Study. Chonnam Med J 2017; 53:153-160. [PMID: 28584795 PMCID: PMC5457951 DOI: 10.4068/cmj.2017.53.2.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 01/18/2023] Open
Abstract
This study aimed to investigate the relationship between carotid atherosclerosis and left ventricular hypertrophy on electrocardiogram (ECG-LVH) on adults living in the community. A total of 9,266 adults who participated in the Namwon Study were included in this analysis. Carotid atherosclerosis, including intima-media thickness (IMT) and plaques, were assessed using high-resolution B-mode ultrasound. ECG-LVH was determined using the Sokolow-Lyon voltage (SokV) and Cornell voltage (CorV) criteria. The prevalence of ECG-LVH was 12.7% using the SokV criteria and 9.7% using the CorV criteria. After full adjustment, compared to the lowest quartile of common carotid artery IMT (CCA-IMT), the odds ratios and 95% confidence intervals for ECG-LVH of the carotid IMT quartiles 2, 3, and 4 increased linearly as follows: 1.54 (1.24-1.90), 1.62 (1.31-2.02), and 1.91 (1.54-2.38), respectively, for the SokV criteria (p<0.001); and 1.33 (1.05-1.68), 1.41 (1.11-1.78), and 1.48 (1.16-1.88), respectively, for the CorV criteria (p=0.003). Positive associations between the carotid bulb IMT (CB-IMT) quartiles and the ECG-LVH were also observed, although the magnitudes of association between CB-IMT and ECG-LVH were slightly lower than those of CCA-IMT. However, no significant association between carotid plaques and ECG-LVH as defined by the SokV or CorV criteria was found. The present study demonstrated that increased carotid IMT, but not carotid plaques, is significantly associated with LVH defined by various ECG criteria in a large population.
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Affiliation(s)
- Nam-Ho Kim
- Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.,Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.,Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jum Suk Ko
- Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.,Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Young-Hoon Lee
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.,Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
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15
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Petersen SS, Pedersen LR, Pareek M, Nielsen ML, Diederichsen SZ, Leósdóttir M, Nilsson PM, Diederichsen ACP, Olsen MH. Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography. Blood Press 2016; 26:54-63. [DOI: 10.1080/08037051.2016.1235959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Søren Sandager Petersen
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | - Line Reinholdt Pedersen
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | - Manan Pareek
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | - Mette Lundgren Nielsen
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | - Søren Zöga Diederichsen
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
| | | | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Michael Hecht Olsen
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Cardiovascular and Metabolic Preventive Clinic, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark
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16
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Johansson JK, Puukka PJ, Niiranen TJ, Varis J, Peltonen M, Salomaa V, Jula AM. Health 2000 score - development and validation of a novel cardiovascular risk score. Ann Med 2016; 48:403-409. [PMID: 27187608 DOI: 10.1080/07853890.2016.1183257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Previous risk scores for predicting myocardial infarctions and strokes have mainly been based on conventional risk factors. We aimed to develop a novel improved risk score that would incorporate other widely available clinical variables for predicting the broadest range of endpoints, including revascularizations. METHODS A nationwide sample of 5843 Finns underwent a clinical examination in 2000-2001. The participants were followed for a median of 11.2 years for incident cardiovascular events. Model discrimination and calibration were assessed and internal validation was performed. RESULTS Sex, age, systolic blood pressure, total cholesterol, HDL cholesterol, smoking status, parental death from cardiovascular disease, left ventricular hypertrophy, hemoglobin A1c, and educational level remained significant predictors of cardiovascular events (p ≤ 0.005 for all). The share of participants with ≥10% estimated cardiovascular risk was 28.9%, 18.5%, 36.9% and 23.8% with the Health 2000, Finrisk, Framingham and Reynolds risk scores. The Health 2000 score (c-statistic: 0.850) showed superior discrimination to the Framingham (c-statistic improvement: 0.021) and Reynolds (c-statistic improvement: 0.007) scores (p < 0.001 for both comparisons). Model including left ventricular hypertrophy, hemoglobin A1c, and educational level improved the model prediction (c-statistic improvement: 0.006, p = 0.003). CONCLUSIONS The Health 2000score improves cardiovascular risk prediction in the current study population. KEY MESSAGES Previous risk scores for predicting myocardial infarctions and strokes have mainly been based on conventional risk factors. We aimed to develop a novel improved risk score that would incorporate other widely available clinical variables (including left ventricular hypertrophy, hemoglobin A1c, and education level) for predicting the broadest range of endpoints, including revascularizations. The Health 2000 score improved cardiovascular risk prediction in the current study population compared with traditional cardiovascular risk prediction scores.
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Affiliation(s)
- Jouni K Johansson
- a Department of Health , National Institute for Health and Welfare , Turku , Finland.,b Department of Medicine , Turku University Hospital , Turku , Finland
| | - Pauli J Puukka
- a Department of Health , National Institute for Health and Welfare , Turku , Finland
| | - Teemu J Niiranen
- a Department of Health , National Institute for Health and Welfare , Turku , Finland.,c The Framingham Heart Study , Boston University , Framingham , MA , USA
| | - Juha Varis
- b Department of Medicine , Turku University Hospital , Turku , Finland
| | - Markku Peltonen
- a Department of Health , National Institute for Health and Welfare , Turku , Finland
| | - Veikko Salomaa
- a Department of Health , National Institute for Health and Welfare , Turku , Finland
| | - Antti M Jula
- a Department of Health , National Institute for Health and Welfare , Turku , Finland
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17
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Szewieczek J, Gąsior Z, Duława J, Francuz T, Legierska K, Batko-Szwaczka A, Hornik B, Janusz-Jenczeń M, Włodarczyk I, Wilczyński K. ECG low QRS voltage and wide QRS complex predictive of centenarian 360-day mortality. AGE (DORDRECHT, NETHERLANDS) 2016; 38:44. [PMID: 27039197 PMCID: PMC5005906 DOI: 10.1007/s11357-016-9907-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/21/2016] [Indexed: 06/05/2023]
Abstract
We examined the electrocardiographic (ECG) findings of centenarians and associated them with >360-day survival. Physical and functional assessment, resting electrocardiogram and laboratory tests were performed on 86 study participants 101.9 ± 1.2 years old (mean ± SD) (70 women, 16 men) and followed for at least 360 days. Centenarian ECGs were assessed for left ventricular hypertrophy (LVH) according to the Romhilt-Estes score, Sokolow-Lyon criteria and Cornell voltage criteria which were positive for 12.8, 6.98, and 10.5 % of participants, respectively. Fifty-two study participants (60 %) survived ≥360 days. Multivariate logistic regression analysis revealed a negative relationship between 360-day survival and the following: R II <0.45 mV adjusted for CRP (odds ratio (OR) = 0.108, 95 % confidence interval (CI) = 0.034-0.341, P < .001), R aVF < 0.35 mV adjusted for CRP (OR = 0.151, 95 % CI = 0.039-0.584, P < .006), Sokolow-Lyon voltage <1.45 mV adjusted for CRP (OR = 0.178, 95 % CI = 0.064-0.492, P = .001), QRS ≥90 ms adjusted for CRP (OR = 0.375, 95 % CI = 0.144-0.975, P = .044), and Romhilt-Estes score ≥5 points adjusted for sex and Barthel Index (OR = 0.459, 95 % CI = 0.212-0.993, P = .048) in single variable ECG models. QRS voltage correlated positively with systolic and pulse pressure, serum vitamin B12 level, sodium, calcium, phosphorous, TIMP-1, and eGFR. QRS voltage correlated negatively with BMI, WHR, serum leptin, IL-6, TNF-α, and PAI-1 levels. QRS complex duration correlated positively with CRP; QTc correlated positively with TNF-α. Results suggest that Romhilt-Estes LVH criteria scores ≥5 points, low ECG QRS voltages (Sokolow-Lyon voltage <1.45 mV), and QRS complexes ≥90 ms are predictive of centenarian 360-day mortality.
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Affiliation(s)
- Jan Szewieczek
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Zbigniew Gąsior
- Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jan Duława
- Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Tomasz Francuz
- Department of Biochemistry, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Legierska
- Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Batko-Szwaczka
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Hornik
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Janusz-Jenczeń
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Iwona Włodarczyk
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Wilczyński
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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