Usefulness of echocardiographic and electrocardiographic left ventricular hypertrophy in predicting new cardiac events and atherothrombotic brain infarction in elderly patients with systemic hypertension or coronary artery disease

We performed a prospective study to correlate echocardiographic and electrocardiographic left ventricular (LV) hypertrophy with new cardiac events and atherothrombotic brain infarction (ABI) in 360 elderly patients with hypertension or coronary artery disease. The mean follow-up was 37 ± 7 months (range 20-47). Echocardiographic LV hypertrophy was diagnosed if LV mass exceeded 134 g/m² in men and 110g/m² in women. Electrocardiographic LV hypertrophy was diagnosed if the point score of Romhilt and Estes was ≥ 5. New cardiac events occurred in 108 of 182 patients (59%) with echocardiographic LV hypertrophy and in 52 of 178 patients (29%) without echocardiographic LV hypertrophy (p < 0.001). New cardiac events occurred in 25 of 42 patients (60%) with electrocardiographic LV hypertrophy and in 135 of 318 patients (42%) without electrocardiographic LV hypertrophy (p < 0.05). Sensitivity for predicting new cardiac events was 68% for echocardiographic LV hypertrophy and 16% for electrocardiographic LV hypertrophy. New ABI occurred in 60 of 182 patients (33%) with echocardiographic LV hypertrophy and in 21 of 178 patients (12%) without echocardiographic LV hypertrophy (p < 0.001). New ABI occurred in 15 of 42 patients (36%) with electrocardiographic LV hypertrophy and in 66 of 318 patients (21%) without electrocardiographic LV hypertrophy (p < 0.05). Sensitivity for predicting new ABI was 74% for echocardiographic LV hypertrophy and 19% for electrocardiographic LV hypertrophy. Echocardiographic LV hypertrophy was more sensitive than electrocardiographic LV hypertrophy in predicting new cardiac events (4.3 times) and new ABI (4.0 times) in elderly patients with hypertension or coronary artery disease.