Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population ofelderly men

Background-The increased risk associated with left ventricular hypertrophy (LVH) diagnosed echocardiographically (Echo-LVH) or electrocardiographicall y (ECC-LVH) is well known, but the clinically relevant question of how much additional prognostic information would be provided by echocardiographical ly assessing LVH if a subject's ECG-LVH and hypertension status are known h as not been addressed. Methods and Results-We investigated whether Echo-LVH and ECG-LVH predicted total and cardiovascular mortality and morbidity independently of each othe r and of other cardiovascular risk factors by using a population-based samp le of 475 men investigated at age 70 with a median follow-up time of 5.2 ye ars. Echocardiographic left ventricular mass index (LVMI) predicted total m ortality (hazards ratio [HR] 1.44, 95% CI 1.09 to 1.92, for a 1-SD increase in LVMI) and cardiovascular mortality (HR 2,38, 95% CI 1.52 to 3.73) indep endently of ECC-LVH and other cardiovascular risk factors. ECG-LVH, defined as Cornell product > 244 muV(.)s, predicted total mortality (HR 2.89, 95% CI 1.41 to 5.96) independently of LVMI and other cardiovascular risk factor s. Thus, Echo-LVH and ECG-LVH provided complementary prognostic information , especially in hypertensive subjects. Conclusions-Echo-LVH and ECG-LVH predict mortality independently of each ot her and of other cardiovascular risk factors, implying that Echo-LVH and EC G-LVH in part carry different prognostic information. Therefore, to fully a ssess the increased risk associated with these conditions, both ECC and ech ocardiography should be performed.