ECG left ventricular hypertrophy as a risk predictor of sudden cardiac death

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Porthan , K , Kentta , T , Niiranen , T J , Nieminen , M S , Oikarinen , L , Viitasalo , M , Hernesniemi , J , Jula , A M , Salomaa , V , Huikuri , H , Albert , C M & Tikkanen , J T 2019 , ' ECG left ventricular hypertrophy as a risk predictor of sudden cardiac death ' , International Journal of Cardiology , vol. 276 , pp. 125-129 .

Title: ECG left ventricular hypertrophy as a risk predictor of sudden cardiac death
Author: Porthan, Kimmo; Kentta, Tuomas; Niiranen, Teemu J.; Nieminen, Markku S.; Oikarinen, Lasse; Viitasalo, Matti; Hernesniemi, Jussi; Jula, Antti M.; Salomaa, Veikko; Huikuri, Heikki; Albert, Christine M.; Tikkanen, Jani T.
Other contributor: University of Helsinki, Kardiologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Clinicum

Date: 2019-02-01
Language: eng
Number of pages: 5
Belongs to series: International Journal of Cardiology
ISSN: 0167-5273
Abstract: Background: Electrocardiographic (ECG) left ventricular hypertrophy (LVH) is an established risk factor for cardiovascular events. However, limited data is available on the prognostic values of different ECG LVH criteria specifically to sudden cardiac death (SCD). Our goal was to assess relationships of different ECG LVH criteria to SCD. Methods: Three traditional and clinically useful (Sokolow-Lyon, Cornell, RaVL) and a recently proposed (Peguero-Lo Presti) ECG LVH voltage criteria were measured in 5730 subjects in the Health 2000 Survey, a national general population cohort study. Relationships between LVH criteria, aswell as their selected composites, to SCD were analyzed with Cox regression models. In addition, population-attributable fractions for LVH criteria were calculated. Results: After a mean follow-up of 12.5 +/- 2.2 years, 134 SCDs had occurred. When used as continuous variables, all LVH criteria except for RaVL were associated with SCD in multivariable analyses. When single LVH criteria were used as dichotomous variables, only Cornell was significant after adjustments. The dichotomous composite of Sokolow-Lyon and Cornell was also significant after adjustments (hazard ratio for SCD 1.82, 95% confidence interval 1.20-2.70, P = 0.006) and was the only LVH measure that showed statistically significant population attributable fraction (11.0%, 95% confidence interval 1.9-19.2%, P=0.019). Conclusions: Sokolow-Lyon, Cornell, and Peguero-Lo Presti ECG, but not RaVL voltage, are associated with SCD risk as continuous ECG voltage LVH variables. When SCD risk assessment/adjustment is performed using a dichotomous ECG LVH measure, composite of Sokolow-Lyon and Cornell voltages is the preferred option. (c) 2018 The Authors. Published by Elsevier B.V.
Subject: Electrocardiography
Left ventricular hypertrophy
Sudden cardiac death
3121 General medicine, internal medicine and other clinical medicine

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