Abstract 382: Four-tiered Classification of Left Ventricular Hypertrophy Based on Ventricular Concentricity and Dilatation Identifies Ischemic Stroke in the General Population

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Haoyu Wang ◽  
Kefei Dou ◽  
Jiang He ◽  
Zugui Zhang ◽  
Yingxian Sun
Keyword(s):  
Ischemic Stroke ◽  
Left Ventricular Hypertrophy ◽  
Chinese Population ◽  
Large Scale ◽  
Ventricular Hypertrophy ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
End Diastolic Volume ◽  
General Chinese Population

Background: Left ventricular hypertrophy (LVH) is traditionally classified as concentric or eccentric based on LV relative wall thickness. We evaluated the prediction of ischemic stroke in a new 4-group LVH classification based on LV concentricity (mass/end-diastolic volume 0.67 ) and indexed LV end-diastolic volume (EDV) in the general Chinese population. Methods: The cross-sectional study consisted of 11,037 general Chinese population (mean age 54 years; 54% women) from Northeast China Rural Cardiovascular Health (NCRCH) study who underwent echocardiography measurement. A 4-tiered classification of LVH was proposed where eccentric LVH is subdivided into “indeterminate hypertrophy (n=484)” and “dilated hypertrophy (n=386)” and concentric LVH into “thick hypertrophy (n=246)” and “both thick and dilated hypertrophy (n=138)” based on the presence of increased LV end-diastolic volume. Results: Compared with normal LV geometry (2.6%), indeterminate (7.4%) and thick hypertrophy (10.2%) showed a higher prevalence of ischemic stroke (p<0.05). Ischemic stroke was significantly greater in participants with indeterminate (adjusted odd ratio [OR]:1.635, 95% confidence interval [CI]: 1.115–2.398) and thick (2.143 [1.329–3.456]) hypertrophy but not significantly in those with dilated (1.251 [0.803–1.950]) and both thick and dilated hypertrophy (0.926 [0.435–1.971]) compared with normal geometry in multivariable analysis. Additionally, the continuous parameters of LV concentricity 0.67 (OR, 1.067; 95% CI, 1.024–1.113 per 1 SD increment) was independently associated with the presence of ischemic stroke in multivariable analysis adjusted for age, sex, race, physical activity, current smoking and drinking status, BMI, TC, hypertension and diabetes, while LVEDV/BSA was not (OR, 0.957; 95% CI, 0.859–1.065 per 1 SD increment). Conclusions: In a large-scale Asian population, we identified that thick hypertrophy carried the greatest odd for ischemic stroke, independently of traditional risk factors, followed by indeterminate hypertrophy. The new 4-tiered categorization of LVH can permit a better understanding of which subjects are at high enough risk for ischemic stroke to warrant early targeted therapy.

Cornell voltage left ventricular hypertrophy predicts all-cause mortality better than Sokolow-Lyon voltage in patients with and without diabetes – data from 183,749 primary care ECGs

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Haxha ◽  
U Pedersen-Bjergaard ◽  
J.B Nielsen ◽  
J Pallisgaard ◽  
R.B Devereux ◽  
...  
Keyword(s):  
Primary Care ◽  
Left Ventricular Hypertrophy ◽  
Predictive Value ◽  
Ventricular Hypertrophy ◽  
Strong Predictor ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Type I ◽  
All Cause Mortality ◽  
Cornell Voltage

Abstract Background Cornell voltage criteria (CL) and Sokolow-Lyon criteria (SL) for electrocardiographic left ventricular hypertrophy (ECG-LVH) are well known predictors of cardiovascular outcome. However, their predictive value may differ according to patient type and remains to be further tested in diabetic mellitus (DM) patients. Purpose The present study aims to determine the prevalence of each ECG-LVH criteria and their respective predictive value in DM patients. Method A retrospective cohort study of individuals age &gt;40 years with digital ECGs from primary care were collected during 2001 to 2011. Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. DM was defined if individuals were prescribed oral antidiabetics or insulin, if they were diagnosed with DM type I or II, or had a HbA1c&gt;48 mmol/l. Cox multivariable analysis was used for estimating hazard ratio (HR) and 95% confidence intervals (95% CI) for all-cause mortality during follow-up of up to 17 years. Results Included were 183,749 individuals with a digital ECG collected in primary care. A total of 13,003 (7.1%) individuals had DM, they were older (65.8 vs. 61.3 years), had more myocardial infarction (16.1% vs. 5.2%), stroke (14.4% vs. 6.2%), hypertension (35.1% vs. 13.2%), CL LVH (8.0% vs. 5.6%) and more were males (53.3% vs. 45.3%) compared to the non-DM individuals (all p&lt;0.001). CL identified a larger percentage of LVH in DM compared to non-DM individuals (8.0% vs. 5.6%, p&lt;0.001), whereas SL identified similar percentage LVH in DM and non-DM individuals (8.5% vs. 8.1%, p=0.068). In multivariable adjusted analysis CL LVH remained strongly associated with all-cause mortality [HR 1.45 (95% CI: 1.42–1.48)] compared to SL LVH which found only a modest association [HR 1.06 (95% CI: 1.03–1.10)] (Figure 1). Of note, the association of CL LVH and all-cause mortality was even stronger than DM per se. There was no interaction with DM and either ECG LVH criteria (p&gt;0.45). Conclusion Cornell Voltage Left Ventricular Hypertrophy is a strong predictor of mortality in patients with and without diabetes and an independent risk factor compared to hypertension and diabetes. The predictive value was substantially stronger than Sokolow-Lyon Voltage criteria for hypertrophy. Figure 1. LVH and all-cause mortality Funding Acknowledgement Type of funding source: None

scholarly journals A 4-Tiered Classification of Left Ventricular Hypertrophy Based on Left Ventricular Geometry

2010 ◽  
Vol 3 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Michel G. Khouri ◽  
Ronald M. Peshock ◽  
Colby R. Ayers ◽  
James A. de Lemos ◽  
Mark H. Drazner
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry

scholarly journals Prevalence and pattern of echocardiographic abnormalities among patients on haemodialysis at an urban hospital in Central Uganda

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Grace Kansiime ◽  
Robert Kalyesubula ◽  
Emmy Okello ◽  
Ponsiano Ocama
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diastolic Dysfunction ◽  
Ventricular Hypertrophy ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Sub Saharan Africa ◽  
Chronic Haemodialysis ◽  
Urban Hospital ◽  
Cardiac Abnormalities ◽  
High Prevalence

Background: Cardiovascular disease is the most common cause of morbidity and premature mortality in patients on chronic haemodialysis. There are limited data on cardiac abnormalities among these patients in sub-Saharan Africa, including Uganda. We determined the prevalence and patterns of echocardiographic (echo) abnormalities among patients with end-stage renal disease (ESRD) on haemodialysis at Mulago National Referral Hospital, Kampala, Uganda. Methods: Eighty patients with ESRD on chronic haemodialysis were enrolled in the study over a period of five months from November 2017 to March 2018. We collected data on demographic and baseline clinical characteristics by reviewing charts and conducting patient interviews. Participants had blood pressure measurements performed and blood samples taken for laboratory investigations. We then conducted a cardiac evaluation using standard transthoracic echo protocols. Bivariable and multivariable analysis was performed to study associations with left ventricular hypertrophy and diastolic dysfunction. Results: Fifty-three of the 80 patients (66%) were male, mean age was 49 ± 16 years and the median duration on dialysis was 9.5 months (interquartile range 4–24 months). Twenty-eight (35%) had to travel >50 km to access dialysis. Seventy-four patients (93%) had at least one cardiac echo abnormality and 30% had at least three abnormalities. Left ventricular hypertrophy (68%) and diastolic dysfunction (64%) were the most common abnormalities. There was a high prevalence of factors that have previously been associated with left ventricular hypertrophy and diastolic dysfunction including anaemia (79%), poorly controlled hypertension (79%) and dyslipidaemia (56%) but none of these was statistically significantly associated in this study. Conclusions: Our study confirmed a high prevalence of cardiac abnormalities among a young population of African patients with ESRD on chronic dialysis. We recommend that echocardiography be part of the routine care to help plan early intervention for those at high risk of cardiovascular events.

scholarly journals ECHOCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY IN ISCHEMIC STROKE OR TIA: MORE THAN A SIMPLE TARGET ORGAN DAMAGE: PP.4.140

2010 ◽  
Vol 28 ◽  
pp. e90
Author(s):  
L Castilla Guerra ◽  
MC Fernandez Moreno ◽  
J Alvarez Suero ◽  
E Carmona Nimo ◽  
N Vargas ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ
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