Larsen CT, Dahlin J, Blackburn H, et al. Prevalence and prognosis of electrocardiographic left ventricular hypertrophy, ST segment depression and negative T wave; the Copenhagen City Heart Study. Eur Heart J 2002;23:315-24

Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Bispebjerg, 2400 NV, Denmark.
European Heart Journal (Impact Factor: 15.2). 03/2002; 23(4):315-24. DOI: 10.1053/euhj.2001.2774
Source: PubMed


To evaluate the prevalence and the independent prognosis of electrocardiographic left ventricular hypertrophy by voltage only, ST depression and negative T wave, isolated negative T wave and left ventricular hypertrophy plus ST depression and negative T wave for cardiac morbidity and mortality, without known ischaemic heart disease at baseline. METHODS and
Follow-up data from the Copenhagen City Heart Study were used. Subjects were 5243 men and 6391 women, age range 25-74 years. End-points were (1) myocardial infarction, (2) ischaemic heart disease and (3) cardiovascular disease mortality. Relative risk was age- and sex-adjusted, and multivariately adjusted for known cardiovascular risk factors. During 7 years follow-up, left ventricular hypertrophy plus ST depression and negative T wave had an age-adjusted relative risk of 3.78 (95% confidence interval 2.29-6.25) for myocardial infarction, 4.27 (2.95-6.16) for ischaemic heart disease and 3.75 (2.41-5.85) for cardiovascular disease. A negative T wave, ST depression and negative T wave changes, and left ventricular hypertrophy with negative T wave also carry independent prognostic information for myocardial infarction, ischaemic heart disease and cardiovascular disease.
Electrocardiographic left ventricular hypertrophy with ST depression and negative T wave changes are the electrocardiographic abnormalities with the greatest prognostic information for future cardiac events. Electrocardiographic negative T waves, ST depression and negative T wave abnormalities and left ventricular hypertrophy with negative T waves, also have prognostic information.

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    • "The presences of diabetes [40] and high BMI [8,9] have shown significant correlations with LVH in most studies. However, in our study, neither history of diabetes nor the type of treatments for hyperglycemia showed any association with LVH. "
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    BMC Research Notes 01/2014; 7(1):45. DOI:10.1186/1756-0500-7-45
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    • "Some studies have tried to investigate pooled categories by combining some of the abnormalities above for improving the prognostic value. The pool categories used include major and minor abnormalities [61], ECG strain pattern [62, 63], and ischemic ECG findings (Minnesota codes I3, IV1–3, V1–3, or VII1) [64]. "
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    • "Strain pattern is a well-known marker of true anatomic LV hypertrophy [22]. Moreover, the strain pattern is associated not only with underlying coronary heart disease [23] but also with CV risk factors, such as diabetes, older age and high BP [24] [25] [26]. "
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    ABSTRACT: Although repolarization abnormalities on ECG are frequent in post-menopausal hypertensive women, their prognostic value in these women is uncertain. We analyzed 908 hypertensive post-menopausal women consecutively included in the PIUMA (Progetto Ipertensione Umbria Monitoraggio Ambulatoriale) study. The median duration of follow-up was 8.6 years (range: 1-21). All women were untreated at entry. Drug treatment during follow-up was adjusted to single individuals. Standard 12-lead ECG was carried out at entry. The Minnesota Coding was used to define minor and major ("typical strain") repolarization abnormalities. prospective observational study in essential hypertension. Mean age at entry was 60 years. At baseline, ECG was normal in 707 women, minor ST-T changes were noted in 152 women, and a typical strain pattern was present in 49 subjects. Predictors of typical strain were age, diabetes and systolic blood pressure (BP). During follow-up there were 119 new cardiovascular (CV) events and 75 all-cause deaths. Typical strain was associated with a threefold higher risk of CV disease (HR: 3.16; 95% CI: 1.59-6.31; p=0.001) after adjustment for the significant influence of age, diabetes, serum creatinine, systolic BP and HDL-cholesterol. Women with minor LV repolarization abnormalities showed a non-significant excess risk of CV disease when compared with women with normal LV repolarization (HR: 1.25; 95% CI: 0.69-2.26; p=0.467). Similar results were obtained for all-cause mortality. Typical strain pattern, an easily detectable marker of altered LV repolarization, identifies post-menopausal hypertensive women at increased risk of CV disease and all-cause mortality.
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