Copyright © 2002 by the European Society of Cardiology.
Prevalence and prognosis of electrocardiographic left ventricular hypertrophy, ST segment depression and negative T-wave. The Copenhagen City Heart Study
a Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Bispebjerg, 2400 NV, Denmark
b Department of Cardiology, Gentofte University Hospital, 2900, Hellerup, Denmark
c Department of Cardiology, Bispebjerg University Hospital, Copenhagen, 2400 NV, Denmark
d Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, U.S.A.
revised April 24, 2001; accepted April 25, 2001
Abstract
Aims To evaluate the prevalence and the independent prognosis of electrocardiographic left ventricular hypertrophy by voltage only, ST depression and negative T wave, isolated negative T wave and left ventricular hypertrophy plus ST depression and negative T wave for cardiac morbidity and mortality, without known ischaemic heart disease at baseline.
Methods and Results Follow-up data from the Copenhagen City Heart Study were used. Subjects were 5243 men and 6391 women, age range 25–74 years. End-points were (1) myocardial infarction, (2) ischaemic heart disease and (3) cardiovascular disease mortality. Relative risk was age- and sex-adjusted, and multivariately adjusted for known cardiovascular risk factors. During 7 years follow-up, left ventricular hypertrophy plus ST depression and negative T wave had an age-adjusted relative risk of 3·78 (95% confidence interval 2·29–6·25) for myocardial infarction, 4·27 (2·95–6·16) for ischaemic heart disease and 3·75 (2·41–5·85) for cardiovascular disease. A negative T wave, ST depression and negative T wave changes, and left ventricular hypertrophy with negative T wave also carry independent prognostic information for myocardial infarction, ischaemic heart disease and cardiovascular disease.
Conclusions Electrocardiographic left ventricular hypertrophy with ST depression and negative T wave changes are the electrocardiographic abnormalities with the greatest prognostic information for future cardiac events. Electrocardiographic negative T waves, ST depression and negative T wave abnormalities and left ventricular hypertrophy with negative T waves, also have prognostic information.
Key Words: Electrocardiographic, left ventricular hypertrophy, prognosis, epidemiology, risk factors
f1 Correspondence: Carsten Toftager Larsen, MD, Department of Cardiology, Copenhagen University Hospital, Amtssygehuset i Gentofte, 2900 Hellerup, Denmark.
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