Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Abstract

Background: Electrocardiography (ECG) has low sensitivity for detecting left ventricular hypertrophy (LVH), while echocardiography cannot be routinely performed. Design/methods: In this study we evaluate the prevalence of LVH and diastolic dysfunction in hypertensive patients with normal ECG. We excluded patients with cardiovascular (CV) diseases, diabetes, chronic kidney disease, or presenting ECG-LVH or other ECG anomalies. The enrolled 440 hypertensive patients underwent echocardiographic examination (Acuson Sequoia 512); LV mass was indexed by body surface area (LVMI) and LVH was defined as LVMI >125 g/m 2 in men and >110 g/m 2 in women. Diastolic function was evaluated by mitral inflow and tissue Doppler imaging (TDI). Results: The prevalence of LVH was 8.18% (95% confidence interval [CI] 5.97-11.1%). Multiple regression analysis showed that the only variable independently associated with LVH was duration of hypertension (p < 0.001). The receiver operating characteristic (ROC) curve showed that duration of hypertension was a powerful predictor of LVH, with an area under the curve (AUC) of 0.878 and p < 0.0001. Further, in patients with LVH the mean difference of LVMI from the cut-off value for LVH was 12.3 AE 9.19 g/m 2 . Diastolic dysfunction, defined as early diastolic myocardial velocity (Em) <0.08 m/s, was detected only in 3.2% of patients. Conclusions: The prevalence of LVH among hypertensive patients with normal ECG, free of diabetes and of CV diseases is low; moreover, patients with echocardiographic LVH presented LVMI values that identified mild LVH. Few cases of impaired diastolic function were registered. We suggest that in hypertensive patients with such characteristics the echocardiographic examination should be reserved to those who present with higher duration of hypertension.

Left ventricular hypertrophy among black hypertensive patients: focusing on the efficacy of angiotensin converting enzyme inhibitors

“…Duration of hypertension was found to be an independent predictor of left ventricular hypertrophy in our study which is consistent with most studies from around the world [ 42 , 43 ].…”

Development of a nomogram for screening the risk of left ventricular hypertrophy in Chinese hypertensive patients

“…Until now, only a small number of prediction models for left ventricular mass have been reported. 6 , 7 , 8 , 9 However, most of these models were designed using the Caucasian populations. Previous studies have proposed that ethnic disparities in the prevalence of LVH exist.…”

Frequency and Risk Factors of Left Ventricular Geometric Abnormalities in Hypertensive Patients: A Study Based on the Updated Classification System of Left Ventricular Geometry

“…They reported that concentric LV remodeling was the most common geometric pattern (9.4%), followed by eccentric non-dilated LVH (6.3%). Compared to normal LV geometry, concentric LVH predicted cardiovascular risk of cardiovascular mortality by 4.04fold, dilated LVH by 3.83-fold, and eccentric nondilated LVH by 2.61-fold after adjustment for baseline covariates, including ambulatory blood pressure [13][14][15][16][17][18] .…”