Combination of electrocardiographic and echocardiographic information identifies individuals prone to a progressive increase in left ventricular mass over 5 years.
OBJECTIVE
We assessed whether the relationship between electrocardiographic and echocardiographic information on left ventricular hypertrophy predicts the development of left ventricular mass over 5 years.


METHODS
Linear regression analyses between various electrocardiographic indices of left ventricular hypertrophy and left ventricular mass (echocardiography) indexed to height2.7 (LVMI(ht)) was performed in 1488 individuals in each gender subgroup (45-79 years, 841 female, exclusion of intraventricular conduction defects) from the population-based, longitudinal 'Study of Health in Pomerania'. A parameter expressing the difference between observed ECG indices of left ventricular hypertrophy and ECG indices predicted on the basis of echocardiographic readings was calculated in each individual at the baseline visit.


RESULTS
In individuals with complete echocardiographic data at baseline and 5-year-follow-up (n = 1031, exclusion of aortic valve disease), LVMI(ht) at 5-year-follow-up was significantly correlated with the parameter derived from the Cornell product (P < 0.001), the Cornell voltage (P < 0.001), the Gubner-Ungerleider-product (P < 0.001), the Gubner-Ungerleider-voltage (P < 0.001), Lewis voltage (P < 0.001) and aVL voltage (P < 0.001), but not with Sokolow-Lyon-index-derived parameters. LVMI(ht) at baseline did not significantly correlate with any of these ECG-derived parameters. In female individuals with Cornell products higher than expected based on echocardiographic readings, left ventricular mass increased from 162.3 +/- 2.6 g to 180.5 +/- 2.8 g (males: 213.1 +/- 3.7 g to 236.3 +/- 4.2 g), whereas left ventricular mass increased only from 161.8 +/- 2.5 g to 173.5 +/- 2.8 g (males: 209.7 +/- 3.7 g to 215.8 +/- 3.7 g) in individuals with lower than expected Cornell products (P < 0.001).


CONCLUSIONS
The relationship of electrocardiographic and echocardiographic information on left ventricular mass may identify individuals at risk for developing progressive increase in left ventricular mass.
Reffelmann
Thorsten
T
aKlinik und Poliklinik für Innere Medizin B, Universitätsklinikum, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany. ThorstenReffelmann@web.de
Dörr
Marcus
M
Völzke
Henry
H
Kors
Jan
J
Ruppert
Jörg
J
Robinson
Daniel
D
Felix
Stephan B
SB
D000328:Adult; D000368:Aged; D018450:Disease Progression; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors