title: Do Combined Electrocardiographic and Echocardiographic Markers of Left Ventricular Hypertrophy Improve Cardiovascular Risk Estimation?
abstract: The authors estimated the risk of cardiovascular mortality associated with echocardiographic (ECHO) left ventricular hypertrophy (LVH) and subtypes of this phenotype in patients with and without electrocardiographic (ECG) LVH. A total of 1691 representatives of the general population were included in the analysis. During a follow-up of 211 months, 89 cardiovascular deaths were recorded. Compared with individuals with neither ECHO LVH nor ECG LVH, fully adjusted risk of cardiovascular mortality increased (hazard ratio [HR], 3.36; 95% confidence interval [CI], 1.51-7.47; P=.003) in patients with both ECHO-LVH and ECG-LVH, whereas the risk entailed by ECHO-LVH alone was of borderline statistical significance (P=.04). Combined concentric nondilated LVH and ECG-LVH, but not concentric nondilated LVH alone, predicted cardiovascular death (HR, 3.79; 95% CI, 1.25-11.38; P=.01). Similar findings were observed for eccentric nondilated LVH (HR, 3.37; 95% CI, 1.05-10.78; P=.04.). The present analysis underlines the value of combining ECG and ECHO in the assessment of cardiovascular prognosis related to abnormal left ventricular geometric patterns.
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it.|Istituto Auxologico Italiano IRCCS, Milano, Italy. cesare.cuspidi@unimib.it.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.affiliation: University Clinical Hospital Centre "Dragisa Misovic", Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.|IRCCS Multimedica, Milano, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.|Istituto Auxologico Italiano IRCCS, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors