Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.

<h4>Background and aims</h4>Electrocardiography (ECG) is the most widely used initial screening test for the assessment of left ventricular hypertrophy (LVH), an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). However, traditional ECG cr...

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Autores principales:	Seung Jun Kim, Hyung Jung Oh, Dong Eun Yoo, Dong Ho Shin, Mi Jung Lee, Hyoung Rae Kim, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo, Kyu Hun Choi, Shin-Wook Kang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/87194663be8f461da19af407f3c8ded3
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spelling	oai:doaj.org-article:87194663be8f461da19af407f3c8ded32021-11-18T07:21:53ZElectrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.1932-620310.1371/journal.pone.0035534https://doaj.org/article/87194663be8f461da19af407f3c8ded32012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22530043/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and aims</h4>Electrocardiography (ECG) is the most widely used initial screening test for the assessment of left ventricular hypertrophy (LVH), an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). However, traditional ECG criteria based only on voltage to detect LVH have limited clinical utility for the detection of LVH because of their poor sensitivity.<h4>Methods</h4>This prospective observational study was undertaken to compare the prognostic significance of commonly used ECG criteria for LVH, namely Sokolow-Lyon voltage (SV) or voltage-duration product (SP) and Cornell voltage (CV) or voltage-duration product (CP) criteria, and to investigate the association between echocardiographic LV mass index (LVMI) and ECG-LVH criteria in ESRD patients, who consecutively started maintenance hemodialysis (HD) between January 2006 and December 2008.<h4>Results</h4>A total of 317 patients, who underwent both ECG and echocardiography, were included. Compared to SV and CV criteria, SP and CP criteria, respectively, correlated more closely with LVMI. In addition, CP criteria provided the highest positive predictive value for echocardiographic LVH. The 5-year cardiovascular survival rates were significantly lower in patients with ECG-LVH by each criterion. In multivariate analyses, echocardiographic LVH [adjusted hazard ratio (HR): 11.71; 95% confidence interval (CI): 1.57-87.18; P = 0.016] and ECG-LVH by SP (HR: 3.43; 95% CI: 1.32-8.92; P = 0.011) and CP (HR: 3.07; 95% CI: 1.16-8.11; P = 0.024) criteria, but not SV and CV criteria, were significantly associated with cardiovascular mortality.<h4>Conclusions</h4>The product of QRS voltage and duration is helpful in identifying the presence of LVH and predicting cardiovascular mortality in incident HD patients.Seung Jun KimHyung Jung OhDong Eun YooDong Ho ShinMi Jung LeeHyoung Rae KimJung Tak ParkSeung Hyeok HanTae-Hyun YooKyu Hun ChoiShin-Wook KangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e35534 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Seung Jun Kim Hyung Jung Oh Dong Eun Yoo Dong Ho Shin Mi Jung Lee Hyoung Rae Kim Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Kyu Hun Choi Shin-Wook Kang Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
description	<h4>Background and aims</h4>Electrocardiography (ECG) is the most widely used initial screening test for the assessment of left ventricular hypertrophy (LVH), an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). However, traditional ECG criteria based only on voltage to detect LVH have limited clinical utility for the detection of LVH because of their poor sensitivity.<h4>Methods</h4>This prospective observational study was undertaken to compare the prognostic significance of commonly used ECG criteria for LVH, namely Sokolow-Lyon voltage (SV) or voltage-duration product (SP) and Cornell voltage (CV) or voltage-duration product (CP) criteria, and to investigate the association between echocardiographic LV mass index (LVMI) and ECG-LVH criteria in ESRD patients, who consecutively started maintenance hemodialysis (HD) between January 2006 and December 2008.<h4>Results</h4>A total of 317 patients, who underwent both ECG and echocardiography, were included. Compared to SV and CV criteria, SP and CP criteria, respectively, correlated more closely with LVMI. In addition, CP criteria provided the highest positive predictive value for echocardiographic LVH. The 5-year cardiovascular survival rates were significantly lower in patients with ECG-LVH by each criterion. In multivariate analyses, echocardiographic LVH [adjusted hazard ratio (HR): 11.71; 95% confidence interval (CI): 1.57-87.18; P = 0.016] and ECG-LVH by SP (HR: 3.43; 95% CI: 1.32-8.92; P = 0.011) and CP (HR: 3.07; 95% CI: 1.16-8.11; P = 0.024) criteria, but not SV and CV criteria, were significantly associated with cardiovascular mortality.<h4>Conclusions</h4>The product of QRS voltage and duration is helpful in identifying the presence of LVH and predicting cardiovascular mortality in incident HD patients.
format	article
author	Seung Jun Kim Hyung Jung Oh Dong Eun Yoo Dong Ho Shin Mi Jung Lee Hyoung Rae Kim Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Kyu Hun Choi Shin-Wook Kang
author_facet	Seung Jun Kim Hyung Jung Oh Dong Eun Yoo Dong Ho Shin Mi Jung Lee Hyoung Rae Kim Jung Tak Park Seung Hyeok Han Tae-Hyun Yoo Kyu Hun Choi Shin-Wook Kang
author_sort	Seung Jun Kim
title	Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
title_short	Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
title_full	Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
title_fullStr	Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
title_full_unstemmed	Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
title_sort	electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/87194663be8f461da19af407f3c8ded3
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Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients.

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