The Prognostic Role of Left Ventricular Hypertrophy in Patients with or without Coronary Artery Disease

Ghali, Jalal K.; Liao, Youlian; Simmons, Brian E.; Castañer, Angel; Cao, Guichan; Cooper, Richard S.

doi:10.7326/0003-4819-117-10-831

Cited by 433 publications

(218 citation statements)

References 29 publications

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“…In a study carried out in a predominantly black population with established CAD, the prevalence of echocardiography (echo) LVH was as high as 50%. 2 We recently found similar figures, 3 while according to Framingham, the prevalence would be around 30-35% in controls. Secondly, in a comparative study in CAD patients, Liao et al 4 showed that the independent relative risk of cardiac death conferred by LVH was higher (2.4) and accounted for more deaths than multivessel coronary disease (relative risk ¼ 1.6) or LV systolic dysfunction (relative risk ¼ 2.0).…”

Section: Introductionmentioning

confidence: 63%

The electrocardiogram is an unreliable method of identifying left ventricular hypertrophy in stable, treated angina patients

Ang

Struthers

2008

J Hum Hypertens

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In coronary artery disease (CAD), a potentially reversible factor leading to cardiac death is left ventricular hypertrophy (LVH). While the electrocardiogram (ECG) is a widely available way to diagnose LVH, its sensitivity and specificity has never been assessed in this particular patient group where added ischaemic changes on ECG might complicate things. Furthermore, there are at least 11 different ECG criteria proposed to identify LVH. We sought to determine how many cases of echocardiography (echo) LVH would be missed if all of these different ECG criteria were applied in a group of stable, treated angina patients. A total of 241 consecutive patients with angiographically confirmed CAD were prospectively recruited and 11 ECG criteria were assessed on each subject and compared with the presence or absence of LVH on echo. Individual sensitivity, specificity, positive predictive value and negative predictive value were calculated for each ECG LVH criteria. The prevalence of echo LVH in the entire CAD population was 43%. All the proposed ECG criteria were poor at identifying echo LVH. The Cornell product yielded the highest rate of change value but still missed up to 80% of the echo LVH cases. We conclude that in a group of stable, treated angina patients, ECG is an unreliable method of identifying LVH. As LVH is very common in this patient population, screening by means of echo might be indicated. This will enable intensified efforts to ensure LVH regression, which is associated with reduction in both cardiovascular morbidity and mortality.

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Section: Introductionmentioning

confidence: 63%

The electrocardiogram is an unreliable method of identifying left ventricular hypertrophy in stable, treated angina patients

Ang

Struthers

2008

J Hum Hypertens

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“…Emerging data from echocardiographic investigations indicate that increased left ventricular mass is associated with greater risk for cardiovascular morbidity and mortality. [19][20][21][22] Echocardiographic studies also reveal that antihypertensive treatment can regress LVH in selected hypertensive patients.2324 However, it is not known if regression of LVH on the echocardiogram or on the ECG will reduce the excess burden of cardiovascular disease associated with this condition.…”

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confidence: 99%

Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy.

et al. 1994

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“…1,2 The prognostic relevance of LV geometry has also been investigated. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Various studies [3][4][5][6] have repeatedly reported that LV hypertrophy is associated with increased cardiovascular risk.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular risk in subjects with left ventricular concentric remodeling at baseline examination: a meta-analysis

Pierdomenico¹,

Nicola

Pierdomenico³

et al. 2011

J Hum Hypertens

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It is debated whether subjects with concentric remodeling (CR, normal left ventricular mass index (LVMI) and increased relative wall thickness (RWT)) are at higher cardiovascular risk than those with normal geometry (NG, normal LVMI and RWT). The aim of this study was to perform a meta-analysis of studies evaluating cardiovascular events in subjects with CR and NG according to baseline classification. We searched for articles evaluating cardiovascular outcome in subjects with CR compared with those with NG, and reporting adjusted hazard ratio (HR) and 95% confidence interval (CI). Six studies were included in the meta-analysis. The pooled population consisted of 7465 subjects with CR and NG. During the follow-up, they experienced 852 events. When compared with NG, the overall adjusted HR was 1.36 (95% CI 1.03-1.78) for CR, Po0.03. There was some heterogeneity between studies. Subgroup meta-analysis showed that increased cardiovascular risk in subjects with CR was more relevant in studies evaluating hypertensive and Caucasian subjects and reporting both fatal and non-fatal events. Cardiovascular risk is significantly higher in subjects with CR than in those with NG. This aspect is more evident in studies including hypertensive patients and Caucasian populations and reporting global cardiovascular risk.

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The Prognostic Role of Left Ventricular Hypertrophy in Patients with or without Coronary Artery Disease

Abstract: Echocardiographically determined left ventricular hypertrophy is an important prognostic marker in patients with or without coronary artery disease. The effect of reversing ventricular hypertrophy in patients with and without coronary disease deserves further study.

Cited by 433 publications

References 29 publications

The electrocardiogram is an unreliable method of identifying left ventricular hypertrophy in stable, treated angina patients

The electrocardiogram is an unreliable method of identifying left ventricular hypertrophy in stable, treated angina patients

Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy.

Cardiovascular risk in subjects with left ventricular concentric remodeling at baseline examination: a meta-analysis

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