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Prognostic value of a new electrocardiographic method for diagnosis of left ventricular hypertrophy in essential hypertension.
- Source :
-
Journal of the American College of Cardiology [J Am Coll Cardiol] 1998 Feb; Vol. 31 (2), pp. 383-90. - Publication Year :
- 1998
-
Abstract
- Objectives: We tested the prognostic value of a new electrocardiographic (ECG) method (Perugia score) for diagnosis of left ventricular hypertrophy (LVH) in essential hypertension and compared it with five standard methods (Cornell voltage, Framingham criterion, Romhilt-Estes point score, left ventricular strain, Sokolow-Lyon voltage).<br />Background: Several standard ECG methods for assessment of LVH are used in the clinical setting, but a comparative prognostic assessment is lacking.<br />Methods: A total of 1,717 white hypertensive subjects (mean age 52 years; 51% men) were prospectively followed up for up to 10 years (mean 3.3).<br />Results: At entry, the prevalence of LVH was 17.8% (Perugia score), 9.1% (Cornell), 3.9% (Framingham), 5.2% (Romhilt-Estes), 6.4% (strain) and 13.1% (Sokolow-Lyon). During follow-up there were 159 major cardiovascular morbid events (33 fatal). The event rate was higher in the subjects with than in those without LVH (all p < 0.001) according to all methods except the Sokolow-Lyon method. By multivariate analysis, an independent association between LVH and cardiovascular disease risk was maintained by the Perugia score (hazard ratio [HR] 2.04, 95% confidence interval [CI] 1.5 to 2.8) and the Framingham (HR 1.91, 95% CI 1.1 to 3.2), Romhilt-Estes (HR 2.63, 95% CI 1.7 to 4.1) and strain methods (HR 2.11, 95% CI 1.4 to 3.2). The Perugia score showed the highest population-attributable risk for cardiovascular events, accounting for 15.6% of all cases, whereas the Framingham, Romhilt-Estes and strain methods accounted for 3.0%, 7.4% and 6.8% of all events, respectively. LVH diagnosed by the Perugia score was also associated with an increased risk of cardiovascular mortality (HR 4.21, 95% CI 2.1 to 8.7), with a population-attributable risk of 37.0%.<br />Conclusions: The Perugia score carried the highest population-attributable risk for cardiovascular morbidity and mortality compared with classic methods for detection of LVH. Traditional interpretation of standard electrocardiography maintains an important role for cardiovascular risk stratification in essential hypertension.
- Subjects :
- Age Factors
Antihypertensive Agents therapeutic use
Arterial Occlusive Diseases etiology
Blood Pressure physiology
Cause of Death
Cerebrovascular Disorders etiology
Confidence Intervals
Coronary Disease etiology
Death, Sudden, Cardiac etiology
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular complications
Hypertrophy, Left Ventricular physiopathology
Ischemic Attack, Transient etiology
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction etiology
Prevalence
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Survival Rate
Ventricular Function, Left physiology
Electrocardiography methods
Hypertension complications
Hypertrophy, Left Ventricular diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0735-1097
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 9462583
- Full Text :
- https://doi.org/10.1016/s0735-1097(97)00493-2