ASSOCIATION OF ELECTROCARDIOGRAPHIC LEFT-VENTRICULAR HYPERTROPHY WITHTHE INCIDENCE OF NEW CONGESTIVE-HEART-FAILURE

OBJECTIVE: To investigate the association of electrocardiographic (ECG ) left ventricular hypertrophy (LVH) with the incidence of new congest ive heart failure (CHF) in older people. DESIGN: In a prospective stud y of 2638 older people, ECGs were obtained at study entry, at 1 month after study entry, when clinically indicated, and at least yearly afte r study entry. ECG LVH was diagnosed if the point score of Romhilt and Estes was greater than or equal to 5. Persistent LVH was diagnosed if all of the ECGs showed LVH. New LVH was diagnosed if the baseline ECG showed no LVH but LVH was present on the last EGG. Regression of LVH was diagnosed if the baseline ECG showed LVH but no LVH was present on the last EGG. No LVH was diagnosed if all of the ECGs showed no LVH. Persistent LVH, new LVH, regression of LVH, and no LVH were correlated with the incidence of new CHF at follow-up. SETTING: A large long-ter m health care facility. PATIENTS: The patients included 1805 women and 833 men, mean age 81 +/- 9 years (range 60 to 103). MEASUREMENTS AND MAIN RESULTS: Of the 2,638 older persons studied, 281 (11%) had persis tent ECG LVH, 31 (1%) had new ECG LVH, 12 (0.5%) had regression of ECG LVH, and 2314 (88%) had no ECG LVH. At 42 +/- 24 months (range 1 to 1 54 months) follow-up, new CHF developed in 168 of 281 persons (60%) wi th persistent LVH, in 16 of 31 persons (52%) with new LVH, in 4 of 12 persons (33 %) with regression of LVH, and in 507 of 2314 persons (22% ) with no LVH. Kaplan-Meier survival curves showed that the developmen t of new CHF was higher in persons with persistent LVH versus regressi on of LVH (P =.013), in persons with persistent LVH versus no LVH (P = .001), in persons with new LVH versus regression of LVH (P =.039), and in persons with new LVH versus no LVH (P =.001). CONCLUSION: Older pe rsons with persistent or new ECG LVH have a higher incidence of new CH F and an earlier time to the development of new CHF than older persons without ECG LVH.