Open AccessElectrocardiographic Predictors of Sudden Cardiac Death in Patients with Left Ventricular Hypertrophy
Author(s) -
Panikkath Ragesh,
Reinier Kyndaron,
UyEvanado Audrey,
Teodorescu Carmen,
Gunson Karen,
Jui Jonathan,
Chugh Sumeet S.
Publication year - 2013
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12003
Subject(s) - medicine , cardiology , left ventricular hypertrophy , sudden cardiac death , ejection fraction , qrs complex , qt interval , sudden death , coronary artery disease , electrocardiography , body mass index , logistic regression , diabetes mellitus , heart failure , blood pressure , endocrinology
Background Left ventricular hypertrophy (LVH) has been associated with increased risk of sudden cardiac death (SCD), and improvements in risk stratification methodology are warranted. Methods We evaluated electrocardiographic intervals as potential markers of SCD risk in LVH. Corrected QT, QRS, and JT intervals were evaluated in consecutive cases with SCD and LVH from the ongoing Oregon Sudden Unexpected Death study who underwent a 12‐lead electrocardiogram (EKG) and echocardiogram prior to and unrelated to the SCD event. Comparisons of age, gender, body mass index, LV ejection fraction, and EKG intervals together with clinical conditions (hypertension and diabetes) were conducted with geographically matched controls that had coronary artery disease but no history of ventricular arrhythmias or cardiac arrest. LVH was determined using the modified American Society of Echocardiography equation for LV mass. Independent samples t ‐test, Pearson's chi‐square test, and multiple logistic regression were used for statistical comparisons. Results Of the 109 cases and 49 controls who met study criteria, age, gender, and comorbidities were similar among cases and controls. The mean LV mass index was not significantly different in cases compared to controls. However mean QTc (470.6 ± 53.6 ms vs 440.7 ± 38.7 ms; P < 0.0001) and QRS duration (113.6 ± 30.0 ms vs 104.9 ± 18.7 ms; P = 0.03) were significantly higher in cases than controls. In logistic regression analysis, prolonged QTc was the only EKG interval significantly associated with SCD (OR 1.72 [1.23–2.40]). Conclusion Prolonged QTc was independently associated with SCD among subjects with LVH and merits further evaluation as a predictor of SCD in LVH.