Electrocardiographic criteria of left ventricular hypertrophy in general population

Casíglia, Edoardo; Schiavon, Laura; Tikhonoff, Valérie; Bascelli, Anna; Martini, Bortolo; Mazza, Alberto; Caffi, Sandro; D’Este, D; Bagato, Francesco; Bolzon, Monica; Guidotti, Federica; Nasto, Hilda Haxhi; Saugo, Mario; Guglielmi, Francesco William; Pessina, Achille C.

doi:10.1007/s10654-008-9234-6

Cited by 48 publications

(41 citation statements)

References 44 publications

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“…[8][9][10][11][12] A group of 1438 subjects matched with cases for age (Ϯ 3 years) and sex, who had no history of cancer and had not experienced either venous (including SVT) or arterial thromboembolic disorders before the beginning of the observation, served as study controls. For 36 cases, only 1 matched control could be identified.…”

Section: Controlsmentioning

confidence: 99%

The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

Prandoni

Casíglia

Tikhonoff

et al. 2011

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Although it has been clearly demonstrated that venous thromboembolism is associated with an increased risk of subsequent overt cancer and arterial cardiovascular events in comparison with control populations, whether this association also applies to patients with isolated (ie, without concomitant involvement of the deep vein system) superficial vein thrombosis (SVT) in the legs is unknown. In 737 consecutive patients with isolated SVT not involving the sapheno-femoral junction, we conducted a retrospective investigation to assess the rate of cancer and that of arterial cardiovascular events occurring during follow-up. The event rates were compared with those occurring in 1438 controls having comparable characteristics. Both cases and controls were followed-up for an average period of 26 ؎ 8 months (range, 3-45). Malignancy was diagnosed in 26 cases (3.5%) and 56 controls (3.9%), leading to a hazard ratio of 0.86 (95% confidence interval, 0.55%-1.35% IntroductionAlthough it has been clearly demonstrated that venous thromboembolism (VTE) is associated with an increased risk of subsequent overt cancer 1 and arterial cardiovascular disorders 2 in comparison with control populations, it is unknown whether this association also applies to patients presenting with isolated (ie, without concomitant involvement of the deep vein system) superficial vein thrombosis (SVT) in the legs. On the basis of anecdotal reports 3 and findings from case-series, 4,5 SVT is generally perceived as a marker of occult malignancy. However, a recent enquiry conducted in The Netherlands in 250 patients with spontaneous SVT and in matched control individuals identified through a search in an electronic database from a few primary health care centers failed to show an increase in the risk of cancer in patients with SVT. 6 In the recently published Calisto study, ϳ 3000 patients with isolated SVT were randomized to receive either fondaparinux or placebo for 45 days. 7 The study showed a remarkable advantage of fondaparinux over placebo for prevention of VTE events during this period. In 737 consecutive patients recruited in 32 centers that agreed to participate in this substudy, a retrospective enquiry was conducted to assess the rate of cancer and that of arterial thromboembolic events occurring after randomization. The event rates were compared with those occurring in 1438 controls having comparable characteristics recruited from the general population of northern Italy. Both cases and controls were followed-up for an average period of more than 2 years. Methods PatientsThe Calisto study recruited 3002 patients 18 years of age or older between March 2007 and May 2009 who had acute symptomatic isolated SVT of the lower extremities at least 5 cm long, as confirmed by standardized compression ultrasonography. 7 Consecutive patients recruited in each of 32 centers that agreed to participate in this substudy were eligible for the current investigation. Patients who had a history of cancer, symptomatic VTE, or symptomatic arterial cardiovascular ...

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Section: Controlsmentioning

confidence: 99%

The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

Prandoni

Casíglia

Tikhonoff

et al. 2011

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“…17 On the other hand, in older subjects, a modest association between ECG parameters of LVH and left ventricular mass detected by echocardiography was found. 22,23 This indicates that the amplitude criteria of LVH have little practical use in detecting LVH in young subjects. Neither from previous studies nor from ours is it clear at what age ECG signs of LVH start to be associated with BP and LVH determined by echocardiography or magnetic resonance.…”

Section: Discussionmentioning

confidence: 99%

Relation of central and brachial blood pressure to left ventricular hypertrophy. The Czech Post-MONICA Study

et al. 2011

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Central blood pressure (BP) has been shown to be a better predictor of target organ damage and cardiovascular events than brachial BP. Whether central BP is a better predictor of left ventricular hypertrophy (LVH) determined by electrocardiography (ECG) is not known. Radial applanation tonometry and ECG were performed in 728 subjects from the Czech Post-MONICA Study (a randomly selected 1% population sample). LVH was determined using the Sokolow-Lyon index and Cornell product; central pressure was derived from radial pulse. Of 657 subjects included in the analysis, 17 (9.4%) below 45 years and 43 (9%) over 45 years had LVH. In multiple linear regression analysis, the Sokolow-Lyon index in younger individuals was only associated with male sex and low BMI, with no association with BP found. In older individuals, LVH was associated with higher central and brachial BP. In separate binary logistic regression analyses adjusted for covariates, the odds ratio for central systolic pressure was higher than those for brachial systolic and pulse pressure in LVH prediction. Noninvasively determined central pressure in subjects over 45 years is more strongly related to ECG LVH than brachial pressure. This further supports a closer association of central pressure with target organ damage. Voltage criteria of LVH are not independently associated with central or brachial BP in younger individuals.

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“…[13][14][15]30 Therefore, ECG test possibly cannot be used only as a surrogate of ECHO in detecting or excluding anatomical LVH. 31 ECHO LVH and ECG LVH have been shown to predict mortality independently of each other, 32 and anatomical ECHO LVH and electrical ECG LVH might reflect a different pathogenesis. 1,[30][31][32] The present data support the clinical utility of ECG LVH positivity determined using Sokolow-Lyon voltage criteria and that it should be used in addition to other methods for assessing the CVD risk.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…31 ECHO LVH and ECG LVH have been shown to predict mortality independently of each other, 32 and anatomical ECHO LVH and electrical ECG LVH might reflect a different pathogenesis. 1,[30][31][32] The present data support the clinical utility of ECG LVH positivity determined using Sokolow-Lyon voltage criteria and that it should be used in addition to other methods for assessing the CVD risk. If ECG is detecting LVH in overweight subjects, it is a good predictor of mortality.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Left ventricular hypertrophy by Sokolow-Lyon voltage criterion predicts mortality in overweight hypertensive subjects

et al. 2008

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In view of the low sensitivity of Sokolow-Lyon voltage criteria in the assessment of electrocardiographic left ventricular hypertrophy (ECG LVH) in overweight subjects, we determined its clinical utility in 1840 lean and 3555 overweight subjects with hypertension. They were followed prospectively over an average of 11 years by the Department of Health and Social Security Hypertension Care Computer Project. LVH was determined at baseline using the Sokolow-Lyon criterion that is, the amplitude voltage SV1 þ (max RV5 or RV6) X3.5 mV. Overweight status was defined as body mass index (BMI) X25 kg m À2 . Prevalence of ECG LVH was 16% in lean and 12% in overweight women, 35 and 20% in lean and overweight men. For each 0.1 mV increase in ECG voltage as a continuous variable, the age and sex adjusted risk of stroke, coronary heart disease and cardiovascular disease (CVD) mortality increased significantly by 3.0, 1.5 and 1.8% in overweight subjects and by 2.8, 1.8 and 2.4% in lean subjects. After additional adjustments for smoking, blood glucose and serum cholesterol concentration in a subgroup of 654 lean and 1281 overweight subjects with complete information on these variables, an increasing voltage still significantly predicted stroke and CVD mortality in overweight subjects. The excess high risk of dying was evident especially in women with LVH in the highest BMI quartiles. When ECG detects LVH in overweight subjects, it is a good predictor of mortality despite the lower sensitivity in this group.

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Electrocardiographic criteria of left ventricular hypertrophy in general population

Cited by 48 publications

References 44 publications

The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs

Relation of central and brachial blood pressure to left ventricular hypertrophy. The Czech Post-MONICA Study

Left ventricular hypertrophy by Sokolow-Lyon voltage criterion predicts mortality in overweight hypertensive subjects

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