Left-Ventricular Hypertrophy in the Elderly: Unreliability of ECG Criteria in 477 Subjects Aged 65 Years or More

Casíglia, Edoardo; Maniati, Giorgia; Daskalakis, Cosmas; Colangeli, Giovanna; Tramontin, Paolo; Ginocchio, Giuliana; Spolaore, Paolo

doi:10.1159/000177132

Cited by 19 publications

(14 citation statements)

References 21 publications

(29 reference statements)

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“…34 In the present study, however, LVH defined by ECG was not significantly different between subjects with and without MBs. As several studies have reported ECG-defined LVH is not reliable, 35,36 which may explain the failure of the association between LVH and MBs in the present study.…”

Section: Discussioncontrasting

confidence: 67%

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

et al. 2009

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Silent cerebral microbleeds (MBs) are a common finding in stroke patients, especially those with intracerebral hemorrhage, and are thought to be a marker of future cerebral hemorrhage. Clinically, two distinct forms of MBs have been documented, those observed with either or both stroke or small vessel disease (SVD) and those associated with cerebral amyloid angiopathy. We investigated a possible association between MBs and arterial stiffness in a general population. Subjects were 443 apparently healthy individuals with a mean age of 67.1 ± 8.1 years. The presence of MBs, lacunar infarcts and periventricular hyperintensity (PVH) was determined by 3-tesla magnetic resonance imaging. Carotid intima-media thickness (IMT) was measured by ultrasonography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV), and the Framingham stroke risk score (FSRS) was obtained as an integrated cerebrovascular risk factor. The prevalence of MBs was 5.0%. Both baPWV and FSRS were significantly higher in subjects with MBs (1820 ± 308 vs. 1645 ± 325 cm/s, P¼0.014 and 12.1 ± 8.6 vs. 8.9 ± 7.5%, P¼0.047, respectively). Odds ratio of a high baPWV, defined as X1500 cm/s, for the presence of MBs was 6.05 even after correction for confounding parameters, including age and hypertension. This association with high baPWV remained irrespective of MBs location, whether strictly located in the lobes or in the basal ganglia and infratentorial regions. These findings indicate an association between arterial stiffness and the presence of MBs. Assessment of arterial stiffness may be useful in identifying subjects at high risk for the presence of MBs.

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Section: Discussioncontrasting

confidence: 67%

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

et al. 2009

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“…Although the hypertensive patients in our study were slightly older than those in corresponding clinical studies, age does not seem to explain the difference in prevalence rates of LVH. [16][17][18]28 It seems more likely that the duration of hypertension and blood pressure levels, in our study, play more important roles in explaining the prevalence of LVH. Most of our LVH patients (62%) had had hypertension for more than 10 years whereas the figure for non-LVH patients was 48%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of left ventricular hypertrophy in Finnish primary health care hypertensive patients

et al. 2001

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Background:Hypertensive patients who present left ventricular hypertrophy (LVH) are at considerable risk of developing cardiovascular complications. Echocardiography, being the best method for assessing of LVH, is too expensive for routine daily practice particularly in primary health care. Therefore, electrocardiogram (ECG) still remains the most feasible method to assess LVH in these settings. Objectives: The aim of this study was to determine the prevalence of ECG-LVH in Finnish hypertensive primary health care patients and evaluate the quality of their blood pressure control. Methods: A total of 255 general practitioners in 26 primary health care centres identified all of their hypertensive patients visiting during a 1-week period. A health examination was carried out on these patients by health

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“…It is known that electrocardiographic and echocardiographic left ventricular hypertrophy reflect two different approaches. The former depends on the electric activity of myocardial fibres (which increase with the pressor load), the latter on the myocardial mass (which can simply increase with growing old due to an accumulation of electrically-inactive connective tissue 58 ). Consequently, in the elderly heart weight detected with echocardiogram has a prognostic value related to that of age, and it is not surprising that it does not predict mortality after correction for age.…”

Section: Discussionmentioning

confidence: 99%

Weak effect of hypertension and other classic risk factors in the elderly who have already paid their toll

et al. 2002

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The aim of the CASTEL, a population-based (n ‫؍‬ 3282) prospective study which began 14 years ago, was to identify those items which had a prognostic impact in the elderly, and to evaluate whether the typical cardiovascular risk factors, particularly arterial hypertension, play a role after the age of 65 years. Initial screening, final follow-up and annual detection of mortality were performed. Mantel-Hanszel approach and multivariate Cox model were used for statistics. Cardiovascular mortality was 23.3% in normotensive, 23.3% in borderline, and 25% in the sustained hypertensive subjects (insignificant difference). In women, the incidence of stroke and coronary artery disease weakly depended on pulse pressure. Historical stroke and myocardial infarction predicted cardiovascular mortality in women; diabetes, uricaemia and high heart rate in men. In the very old, the predictors were less numerous, and blood pressure was not a predictor whatsoever; pulse blood

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Left-Ventricular Hypertrophy in the Elderly: Unreliability of ECG Criteria in 477 Subjects Aged 65 Years or More

Cited by 19 publications

References 21 publications

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

Prevalence of left ventricular hypertrophy in Finnish primary health care hypertensive patients

Weak effect of hypertension and other classic risk factors in the elderly who have already paid their toll

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