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Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients

Authors
 Seung Jun Kim  ;  Hyung Jung Oh  ;  Dong Eun Yoo  ;  Dong Ho Shin  ;  Mi Jung Lee  ;  Hyoung Rae Kim  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Kyu Hun Choi  ;  Shin-Wook Kang 
Citation
 PLOS ONE, Vol.7(4) : e35534, 2012 
Journal Title
 PLOS ONE 
Issue Date
2012
MeSH
Adolescent ; Adult ; Aged ; Echocardiography ; Electrocardiography* ; Female ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular/diagnosis ; Hypertrophy, Left Ventricular/etiology* ; Hypertrophy, Left Ventricular/mortality* ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/complications* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; ROC Curve ; Renal Dialysis ; Young Adult
Keywords
Adolescent ; Adult ; Aged ; Echocardiography ; Electrocardiography* ; Female ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular/diagnosis ; Hypertrophy, Left Ventricular/etiology* ; Hypertrophy, Left Ventricular/mortality* ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/complications* ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; ROC Curve ; Renal Dialysis ; Young Adult
Abstract
BACKGROUND AND AIMS: Electrocardiography (ECG) is the most widely used initial screening test for the assessment of left ventricular hypertrophy (LVH), an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). However, traditional ECG criteria based only on voltage to detect LVH have limited clinical utility for the detection of LVH because of their poor sensitivity. METHODS: This prospective observational study was undertaken to compare the prognostic significance of commonly used ECG criteria for LVH, namely Sokolow-Lyon voltage (SV) or voltage-duration product (SP) and Cornell voltage (CV) or voltage-duration product (CP) criteria, and to investigate the association between echocardiographic LV mass index (LVMI) and ECG-LVH criteria in ESRD patients, who consecutively started maintenance hemodialysis (HD) between January 2006 and December 2008. RESULTS: A total of 317 patients, who underwent both ECG and echocardiography, were included. Compared to SV and CV criteria, SP and CP criteria, respectively, correlated more closely with LVMI. In addition, CP criteria provided the highest positive predictive value for echocardiographic LVH. The 5-year cardiovascular survival rates were significantly lower in patients with ECG-LVH by each criterion. In multivariate analyses, echocardiographic LVH [adjusted hazard ratio (HR): 11.71; 95% confidence interval (CI): 1.57-87.18; P = 0.016] and ECG-LVH by SP (HR: 3.43; 95% CI: 1.32-8.92; P = 0.011) and CP (HR: 3.07; 95% CI: 1.16-8.11; P = 0.024) criteria, but not SV and CV criteria, were significantly associated with cardiovascular mortality. CONCLUSIONS: The product of QRS voltage and duration is helpful in identifying the presence of LVH and predicting cardiovascular mortality in incident HD patients.
Files in This Item:
T201201180.pdf Download
DOI
22530043
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Seung Jun(김승준)
Kim, Hyoung Rae(김형래)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Dong Eun(유동은)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91686
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