This study is funded by National Heart, Lung, and Blood Institute Grant R01HL088416 to Dr. Chugh. Dr. Chugh is the Pauline and Harold Price Professor of Cardiac Electrophysiology at the Cedars-Sinai Medical Center, Los Angeles, California.
Electrocardiographic Predictors of Sudden Cardiac Death in Patients with Left Ventricular Hypertrophy
Article first published online: 22 NOV 2012
©2012, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 18, Issue 3, pages 225–229, May 2013
How to Cite
Panikkath, R., Reinier, K., Uy-Evanado, A., Teodorescu, C., Gunson, K., Jui, J. and Chugh, S. S. (2013), Electrocardiographic Predictors of Sudden Cardiac Death in Patients with Left Ventricular Hypertrophy. Annals of Noninvasive Electrocardiology, 18: 225–229. doi: 10.1111/anec.12003
Disclosures: The authors have no conflicts to disclose.
- Issue published online: 28 MAY 2013
- Article first published online: 22 NOV 2012
- National Heart, Lung, and Blood Institute. Grant Number: R01HL088416
- sudden cardiac death;
- left ventricular hypertrophy;
- QT interval;
- risk prediction
Left ventricular hypertrophy (LVH) has been associated with increased risk of sudden cardiac death (SCD), and improvements in risk stratification methodology are warranted.
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.
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]).
Prolonged QTc was independently associated with SCD among subjects with LVH and merits further evaluation as a predictor of SCD in LVH.