Left ventricular hypertrophy: Effect on survival

Jay M. Sullivan, Roger Vander Zwaag, Faten El-Zeky, K Ramanathan, David M. Mirvis

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Objectives. The aim of the study was to determine whether left ventricular hypertrophy has an independent adverse effect on survival. Background. Left ventricular hypertrophy is considered to be a significant risk factor for coronary heart disease mortality; however, the impact of coexisting coronary artery stenosis on survival statistics is not clear. Methods. The relations among electrocardiographic (ECG) left ventricular hypertrophy, ST-T segment abnormality, coronary artery disease and survival were examined in 18,969 patients undergoing coronary arteriography between 1972 and 1985. Patients were excluded if they underwent coronary revascularization or had unstable angina, rheumatic or congenital heart disease, cardiomyopthy, pericardial disease or ECG changes other than left ventricular hypertrophy or repolarization abnormalities, leaving 4,824 patients for analysis. Results. Left ventricular hypertrophy was present in 249 patients, whereas 4,575 were free of left ventricular hypertrophy. Five-year survival was 90.2% in the group without left ventricular hypertrophy and was significantly lower (81.9%, p < 0.001) in the group with left ventricular hypertrophy. Five-year survival was significantly lower in patients with left ventricular hypertrophy, regardless of whether coronary artery disease was present: 84.4% versus 94.5% (p = 0.016) in the absence of coronary artery disease and 81.0% versus 87.7% (p < 0.001) in the presence of coronary artery disease. The presence of ST abnormalities was not associated with a significant reduction in survival in patients without coronary disease, although mortality was less in those without ST changes who had coronary disease (p = 0.012). Conclusions. It is concluded that ECG left ventricular hypertrophy has an adverse effect on survival, even in patients who are free of coronary artery disease.

Original languageEnglish (US)
Pages (from-to)508-513
Number of pages6
JournalJournal of the American College of Cardiology
Volume22
Issue number2
DOIs
StatePublished - Jan 1 1993

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Left Ventricular Hypertrophy
Survival
Coronary Artery Disease
Coronary Disease
Mortality
Coronary Stenosis
Unstable Angina
Heart Diseases
Angiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Left ventricular hypertrophy : Effect on survival. / Sullivan, Jay M.; Zwaag, Roger Vander; El-Zeky, Faten; Ramanathan, K; Mirvis, David M.

In: Journal of the American College of Cardiology, Vol. 22, No. 2, 01.01.1993, p. 508-513.

Research output: Contribution to journalArticle

Sullivan, Jay M. ; Zwaag, Roger Vander ; El-Zeky, Faten ; Ramanathan, K ; Mirvis, David M. / Left ventricular hypertrophy : Effect on survival. In: Journal of the American College of Cardiology. 1993 ; Vol. 22, No. 2. pp. 508-513.
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abstract = "Objectives. The aim of the study was to determine whether left ventricular hypertrophy has an independent adverse effect on survival. Background. Left ventricular hypertrophy is considered to be a significant risk factor for coronary heart disease mortality; however, the impact of coexisting coronary artery stenosis on survival statistics is not clear. Methods. The relations among electrocardiographic (ECG) left ventricular hypertrophy, ST-T segment abnormality, coronary artery disease and survival were examined in 18,969 patients undergoing coronary arteriography between 1972 and 1985. Patients were excluded if they underwent coronary revascularization or had unstable angina, rheumatic or congenital heart disease, cardiomyopthy, pericardial disease or ECG changes other than left ventricular hypertrophy or repolarization abnormalities, leaving 4,824 patients for analysis. Results. Left ventricular hypertrophy was present in 249 patients, whereas 4,575 were free of left ventricular hypertrophy. Five-year survival was 90.2{\%} in the group without left ventricular hypertrophy and was significantly lower (81.9{\%}, p < 0.001) in the group with left ventricular hypertrophy. Five-year survival was significantly lower in patients with left ventricular hypertrophy, regardless of whether coronary artery disease was present: 84.4{\%} versus 94.5{\%} (p = 0.016) in the absence of coronary artery disease and 81.0{\%} versus 87.7{\%} (p < 0.001) in the presence of coronary artery disease. The presence of ST abnormalities was not associated with a significant reduction in survival in patients without coronary disease, although mortality was less in those without ST changes who had coronary disease (p = 0.012). Conclusions. It is concluded that ECG left ventricular hypertrophy has an adverse effect on survival, even in patients who are free of coronary artery disease.",
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