Comparison of the efficiency between electrocardiogram and echocardiogram for left ventricular hypertrophy evaluation in patients with hypertension: Insight from the Korean Hypertension Cohort Study

Abstract

In patients with hypertension, left ventricular hypertrophy (LVH) represents a risk factor for cardiovascular disease and asymptomatic organ damage. Currently, electrocardiography (ECG) and two-dimensional echocardiography (Echo) are the most widely used methods for LVH evaluation. This study aimed to compare the long-term outcomes of LVH, as evaluated by ECG and Echo, in patients with hypertension. Patients diagnosed with hypertension as a primary disease between 2006 and 2011 were enrolled in the Korean Hypertension Cohort study. The study finally included 1743 patients who underwent both ECG and Echo. The primary endpoint was defined as the composite of major adverse cardiovascular events (MACEs) or death. Overall, LVH was identified in 747 patients. The patients were categorized into four groups accordingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Association between office visit intervals and long‐term cardiovascular risk in hypertensive patients

“…The matched variables were sex and age, on a case‐to‐case basis. The full results have been previously published 12–14 . The study protocols were reviewed and approved by the Institutional Review Boards of each participating hospital, including the coordinating center (H‐1810‐056‐977), and the need to obtain informed consent from patients was waived prior to patient enrollment.…”

Suboptimal control status of young hypertensive population

“…Yet, clinician should be cautious when interpreting high ECG potentials as left ventricular hypertrophy as it can be also seen in young patients with structural heart problem [ 53 ]. In such cases, an echocardiographic study can help confirm left ventricular hypertrophy [ 54 ]. Another cost-effective evaluation tool is urinalysis, which can be used to assess albuminuria.…”

Left ventricular hypertrophy in hypertension: Is the electrocardiogram enough for risk stratification?

“…Finally, a retrospective, populationbased cohort study of older individuals without overt CV disease, documented that ECHO, but not ECG markers of LVH predicted the long-term risk of composite coronary events, heart failure, stroke, or death from any cause. 8 In this complex scenario, the translational implications of Park's study 3 supporting the indication to perform the echocardiogram only in patients with normal ECG, in consideration of its marginal additional prognostic value in patients with ECG-LVH, need some considerations. First, the diagnosis of ECG-LVH was based on three different criteria, but it is not clear which of these criteria played the most important diagnostic role for prognostic stratification, thus leaving this clinical aspect undefined.…”

“…Therefore, we read with great interest and attention the study by Park et al. 3 aimed to investigate the value of LVH, phenotyped by ECG and ECHO criteria, in predicting the composite of major CV events including heart failure, myocardial infarction, peripheral artery disease, ischemic stroke, stroke, end stage renal disease (MACEs) or death among 1743 participants to Korean Hypertension Cohort study over a median 10‐year follow‐up period.…”

“…In this complex scenario, the translational implications of Park's study 3 supporting the indication to perform the echocardiogram only in patients with normal ECG, in consideration of its marginal additional prognostic value in patients with ECG‐LVH, need some considerations. First, the diagnosis of ECG‐LVH was based on three different criteria, but it is not clear which of these criteria played the most important diagnostic role for prognostic stratification, thus leaving this clinical aspect undefined.…”