Key result
Major ECG abnormalities in elderly men linked to increased LVMI and structural or functional LV abnormalities.
Why the study?
Do major electrocardiographic abnormalities correlate with altered left ventricular geometry and function in elderly men?
Cross-Sectional (n=540)
No
Do major electrocardiographic abnormalities correlate with altered left ventricular geometry and function in elderly men?
p-value: p=0.0002
In elderly men, major ECG abnormalities are significantly associated with structural and functional left ventricular abnormalities, suggesting that such ECG findings should prompt suspicion of underlying LV pathology.
Major ECG abnormalities may prompt LV evaluation in elderly men; hypothesis-generating without prospective validation.
We investigated the relationships between echocardiographic indices of left ventricular geometry and function and major electrocardiographic (ECG) abnormalities in 540 elderly (69-74 years old) male participants of a health survey conducted in Uppsala county, Sweden. Comparing men with major ECG abnormalities that were present or absent in various hierarchic mutually exclusive categories, left ventricular mass indexed to body surface area (LVMI) was significantly increased with major Q-waves (P = 0.0002), ST or T-wave abnormalities (P = 0.005), left bundle-branch block (P = 0.005) and also with atrioventricular block type 1 (P = 0.008) and frequent premature beats (P = 0.02). The left atrial diameter was also significantly increased with most ECG abnormalities. The increased LVMI was in left bundle-branch block mainly due to an increased left ventricular diameter, whereas left ventricular wall thickness was increased with frequent premature beats, atrioventricular block type 1 and ST or T-wave abnormalities. The prevalence of Q-waves was highest in eccentric left ventricular hypertrophy, whereas the prevalence of ST or T-wave abnormalities and atrioventricular block type 1 was highest in concentric left ventricular hypertrophy. Both left ventricular systolic (ejection fraction) and diastolic function (E/A) ratio) were inversely related to Sokolow-Lyon QRS amplitude (r = -0.25, P < 0.02 and r = -0.22, P < 0.03 respectively). In conclusion, LVMI was increased in subjects with ECG signs of coronary artery disease as well as in subjects with several other ECG diagnoses. Furthermore, both left ventricular systolic and diastolic dysfunction were related to increased QRS amplitudes. Thus, the finding of ECG abnormalities in elderly men should raise the suspicion of structural and/or functional left ventricular abnormality.
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Sundström et al. (1998) conducted a cross-sectional in Electrocardiographic (ECG) abnormalities (n=540). Major electrocardiographic (ECG) abnormalities vs. Absence of major ECG abnormalities was evaluated on Left ventricular mass indexed to body surface area (LVMI) (p=0.0002). Major ECG abnormalities in elderly men, such as Q-waves, were significantly associated with increased left ventricular mass index (P=0.0002) and structural or functional left ventricular abnormalities.
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