title: Arterial stiffness is the independent factor of left ventricular hypertrophy determined by electrocardiogram.
abstract: BACKGROUND
  Arterial stiffness may contribute to left ventricular hypertrophy (LVH). This study was conducted to evaluate the independent factor of LVH and the quantification of LVH by electrocardiogram (ECG) to predict the degree of aortic stiffness using brachial-ankle pulse wave velocity (baPWV) in subjects with hypertension.
  
  
  METHODS
  A total of 984 consecutive patients who were diagnosed as having essential hypertension were entered into the study. baPWV determination, ECG and blood sampling were performed after a 12-hour overnight fast. LVH was diagnosed using electrocardiography; Romhilt-Estes point score was subsequently calculated. Participants were separated into LVH and non-LVH groups. Additional factors associated with LVH were examined using multivariate analyses.
  
  
  RESULTS
  The non-LVH groups were younger (P = 0.001), had less men (P = 0.001), lower systolic and diastolic blood pressure and pulse pressure (P < 0.001 for each) and lower baPWV (P < 0.001). Stepwise multiple logistic regression analysis demonstrated that sex, age, systolic blood pressure and baPWV are independent factors. Using a baPWV value of 1825 cm/sec, the area under the receiver operating characteristic curve was 0.644 and the highest discriminating sensitivity and specificity were 60% and 65%, respectively.
  
  
  CONCLUSIONS
  Aortic stiffness may be related to electrocardiographically determined LVH in patients with hypertension. Thus, stiffening of large arteries, together with increased systolic blood pressure, seems to significantly contribute to the pathogenesis of LVH. Quantification of LVH by ECG can also predict the degree of aortic stiffness.
authors.affiliation: Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chai Yi Hsien, Taiwan.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Chu
authors.forename: Shih-Tai
authors.initials: ST
authors.lastname: Chang
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Cheng
authors.forename: Teng-Yao
authors.initials: TY
authors.lastname: Yang
authors.forename: Ju-Feng
authors.initials: JF
authors.lastname: Hsiao
authors.forename: Kuo-Li
authors.initials: KL
authors.lastname: Pan
authors.forename: Jen-Te
authors.initials: JT
authors.lastname: Hsu
mesh_terms: D000367:Age Factors; D000368:Aged; D000842:Ankle / Q000098:blood supply; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011673:Pulsatile Flow; D012044:Regression Analysis; D012737:Sex Factors; D013624:Taiwan; D059289:Vascular Stiffness