LEFT-VENTRICULAR GEOMETRY AND FUNCTION ARE RELATED TO ELECTROCARDIOGRAPHIC CHARACTERISTICS AND DIAGNOSES

We investigated the relationships between echocardiographic indices of left ventricular geometry and function and major electrocardiographic (ECG) abnormalities in 540 elderly (69-74 years old) male participant s of a health survey conducted in Uppsala county, Sweden. Comparing me n with major ECG abnormalities that were present or absent in various hierarchic mutually exclusive categories, left ventricular mass indexe d to body surface area (LVMI) was significantly increased with major Q -waves (P = 0.0002), ST or T-wave abnormalities (P = 0.005), left bund le-branch block (P = 0.005) and also with atrioventricular block type 1 (P = 0.008) and frequent premature beats (P = 0.02). The left atrial diameter was also significantly increased with most ECG abnormalities . The increased LVMI was in left bundle-branch block mainly due to an increased left ventricular diameter, whereas left ventricular wall thi ckness was increased with frequent premature beats, atrioventricular b lock type 1 and ST or T-wave abnormalities. The prevalence of Q-waves was highest in eccentric left ventricular hypertrophy, whereas the pre valence of ST or T-wave abnormalities and atrioventricular block type 1 was highest in concentric left ventricular hypertrophy. Both left ve ntricular systolic (ejection fraction) and diastolic function (E/A rat io) were inversely related to Sokolow-Lyon QRS amplitude (r = -0.25, P < 0.02 and r = -0.22, P < 0.03 respectively). In conclusion, LVMI was increased in subjects with ECG signs of coronary artery disease as we ll as in subjects with several other ECG diagnoses. Furthermore, both left ventricular systolic and diastolic dysfunction were related to in creased QRS amplitudes. Thus, the finding of ECG abnormalities in elde rly men should raise the suspicion of structural and/or functional lef t ventricular abnormality.