Hypertrophy at ECG and its regression during treatment survey (HEART survey). Rationale, design and baseline characteristics of patients.
BACKGROUND
Left ventricular hypertrophy (LVH) detected at electrocardiography (ECG) is a predictor of an increased cardiovascular risk in essential hypertension. However, uncertainty remains concerning the reproducibility of ECG LVH and the prognostic relevance of its regression over time in hypertension. The aim of this study was to determine the prognostic value of baseline ECG LVH and its serial changes in a large cohort of hypertensive patients.


METHODS
The Hypertrophy at ECG and its Regression during Treatment Survey (HEART Survey) is a prospective observational study conducted in 66 Italian centers. Inclusion criteria are essential hypertension with ECG LVH defined by the Perugia score (Cornell voltage criteria and/or a typical left ventricular "strain" pattern and/or a Romhilt-Estes score > or = 5 points) in subjects aged 45-84 years. The treatment of hypertension and other risk factors accords with current guidelines and is individually tailored. ECG is recorded twice at entry and periodically repeated over a 4-year follow-up period. Expert readers (unaware of the clinical findings) classify ECG. The incidence of major cardiovascular events in relation to baseline ECG and its changes over time are assessed, together with the reproducibility in the two baseline recordings. Overall, 708 patients aged 64 +/- 9 years have been enrolled in centers from northern (27%), central (32%) and southern (41%) Italy. Their baseline characteristics are presented. Follow-up is ongoing.


CONCLUSIONS
The HEART Survey will examine the prognostic value of baseline ECG LVH and of its regression over time in a wide population of hypertensive patients.
Verdecchia
Paolo
P
ANMCO Research Center, Florence, Italy. verdec@tin.it
Sleight
Peter
P
Avanzini
Fausto
F
de Simone
Giovanni
G
Pede
Sergio
S
Perticone
Francesco
F
Schillaci
Giuseppe
G
Vanuzzo
Diego
D
Angeli
Fabio
F
Reboldi
Gian Paolo
GP
Maggioni
Aldo P
AP
D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000601:surgery*; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000601:surgery*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012107:Research Design; D013223:Statistics as Topic; D016896:Treatment Outcome