Faculty Collaboration Database

Prognostic significance of electrocardiographic right ventricular hypertrophy in the general population. J Electrocardiol 2019;54:49-53

Date

03/23/2019

Pubmed ID

30901607

DOI

10.1016/j.jelectrocard.2019.03.008

Scopus ID

2-s2.0-85063060840 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Echocardiographically detected right ventricular hypertrophy (RVH) is associated with cardiovascular disease (CVD) and mortality. However, the prognostic significance of electrocardiographic (ECG)RVH criteria as predictors of poor outcomes in the general population is unclear.

METHODS: This study included 7857 participants (59.8 ± 13.4 years, 52.6% women) from the Third National Health and Nutrition Examination Survey. Sixteen different ECG-RVH criteria were created from digitally recorded and centrally processed electrocardiograms. All-cause mortality was ascertained using the National Death Index. Cox proportional hazards analysis was used to examine the association between baseline ECG-RVH criteria and all-cause mortality.

RESULTS: The prevalence of RVH varied widely among the criteria. The lowest ECG-RVH prevalence was 0.09% (using S > R in I, II, III) while the highest prevalence was 20.7% (using (R I + S III) - (S I + R III) < 15 mm). During a median follow-up of 14 years, 2812 deaths occurred. The mortality rate was highest among participants with ECG-RVH defined as R:S ratio V₅ < 0.75. In multivariable adjusted models, 9 out of the 16 ECG-RVH criteria were significantly associated with all-cause mortality. When ECG-RVH was defined as the presence of any ECG-RVH criteria, each additional ECG-RVH criteria was associated with 6% increased risk of all-cause mortality (HR (95% CI):1.06(1.03,1.10)).

CONCLUSIONS: There is a wide variation in the prevalence of ECG-RVH when different criteria are applied in the general population. However, the presence of ECG-RVH by most criteria regardless of prevalence was associated with poor prognosis suggesting that appropriate choice of criteria may enhance the utilization of these ECG markers in risk stratification.

Author List

Kowal J, Ahmad MI, Li Y, Soliman EZ

Author

Muhammad Imtiaz Ahmad MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Electrocardiography
Female
Humans
Hypertrophy, Right Ventricular
Male
Middle Aged
Nutrition Surveys
Prevalence
Prognosis
United States