Thresholds in the relationship between mortality and left ventricular hypertrophy defined by electrocardiography

J Electrocardiol. Jul-Aug 2008;41(4):342-50. doi: 10.1016/j.jelectrocard.2007.11.006. Epub 2008 Mar 14.


Background: Electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in current use were defined using autopsy results or echocardiography; criteria defined using mortality might be more clinically meaningful.

Methods: Using data from Third National Health and Nutrition Examination Survey (NHANES III), we selected electrocardiographic measures that best differentiated those surviving at 5 years from those who did not. We identified voltage thresholds using regression techniques and then compared survival for subjects above and below the thresholds.

Results: Cornell voltage, Cornell product, and Novacode estimate of left ventricular mass index were discriminative for mortality and had identifiable thresholds present in their relationships with mortality. Independent of systolic blood pressure, there were significant associations with 5-year mortality for Novacode index above threshold; hazard ratios were 1.58 for women and 1.27 for men, and for 5-year cardiovascular mortality were 1.78 for women and 2.34 for men.

Conclusions: Electrocardiographic criteria for left ventricular hypertrophy validated against mortality might be clinically useful.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Electrocardiography / statistics & numerical data*
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis*
  • Hypertrophy, Left Ventricular / mortality*
  • Incidence
  • Male
  • Middle Aged
  • Risk Assessment / methods*
  • Risk Factors
  • Statistics as Topic
  • Survival Analysis*
  • Survival Rate
  • United States / epidemiology