Left ventricular hypertrophy findings on ECG predicts impaired left atrial functions

Background: Electrocardiographic left ventricular hypertrophy (ECG LVH) has a prognostic value for cardiovascular diseases. Pathological processes that cause development of left ventricular hypertrophy (LVH) also leads to remodeling and dysfunction of the left atrium (LA). Atrial functions can be evaluated by 2D speckle tracking echocardiography. In our study, we aimed to investigate whether the ECG LVH is associated with left atrial strain. Methods : Sixty two patients with LVH according to echocardiographic left ventricle mass index were included in the study. ECG LVH was defined according to: Sokolow- Lyon voltage S V1 +R V5 /R V6 >35mm; Cornell voltage R aVL +SV 3 >28 mm (for men) >20mm (for women); or Cornell product (S V3 +R AVL +(for women 8 mm)) x QRS duration)>2440 mmxms criteria . Patients were categorised into two groups according to presence or absence of ECG LVH. Association between left atrial strain values and ECG findings were evaluated. Results: The mean age of the patients were 58.3±10.1 years; 40.3% were women; 91,9% had hypertension; 35.5% had diabetes. Nineteen patients (30.6%) had ECG LVH according to Sokolow-Lyon voltage, Cornell voltage or Cornell product. Left atrial reservoir, conduit and contraction strains were significantly lower in patients with ECG LVH (p<0.001). Additionally, there was statistically significant correlation between all three phases of left atrial strain values and presence of Sokolow-Lyon voltage (reservoir phase r:-0.389 p<0.01; conduit phase, r:-0.273 p<0.05; contraction phase r:-0.359 p<0.01) Cornell voltage (reservoir phase r:-0.49 p<0.001; conduit phase r:-0.432 p<0.001; contraction phase r:-0. 339 p<0.01) Cornell product (reservoir phase r:-0.471 p<0.001; conduit phase r:-0.387 p<0.01; contraction phase r:-0.362 p<0.01). Conclusion: ECG LVH was associated with left atrial strain and therefore it can be a useful tool to predict left atrial dysfunction.