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Left ventricular hypertrophy and prognosis in patients with chronic heart failure with preserved ejection friction

Glezer M. G., Saigitov R. T., Avakyan A. A., Prourzina N. L.

Keywords: left ventricular hypertrophy, prognosis, preserved ejection fraction, CHF, ECG

DOI: 10.18087/rhfj.2012.1.1627

Relevance. Available data do not allow to judge definitely about the relation of left ventricular hypertrophy (LVH) with high death risk and non-fatal cardiovascular complications in CHF patients. Objective. Study prognostic value of LVH in CHF patients with preserved EF. Materials and methods. Patients with CHF FC II–III with EF >45 % and LVH, confirmed by echoCG data (female >110, male >120 g / m2) were enrolled to the study. Thirteen ECG criteria of LVH were analyzed. Prospective monitoring of patients was carried out during 4 years, with analysis of lethality and hospitalization rate. Results. 56 patients (including 64 % female, mean age 74±7 лет) were enrolled to the study. From 13 analyzed ECG criteria, at leat in one case 10 criteria were LVH-positive. ECG signs of LVH (one or more) were revealed in 43 patients (77 %), more often by Cornell voltage criteria (59 %) and Cornell product criteria (46 %). Patients with these ECG signs of LVH had left ventricular mass (LVM), corrected with height, was by 16–18 % higher than in patients without these signs (p<0.015). Within 4‑year monitoring period, 47 patients (84 %) were hospitalized at least once (main reason – CHF decompensation), 6 deaths were registered (11 % lethality). According to a multifactor analysis, high values of LVM (>401 g) and age (>73 years) were associated with high death risk. ECG signs of LVH were registered in all lethal cases. At the same time lethality in high LVM group was 38 %, and with association of high LVM and at least one ECG sign of LVH, it was 50 %. Conclusion. CHF patients with preserved EF, pronounced LVH is associated with high risk of death. ECG signs of LVH allow to predict disease outcomes more precisely.
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Glezer M. G., Saigitov R. T., Avakyan A. A. et al. Left ventricular hypertrophy and prognosis in patients with chronic heart failure with preserved ejection friction. Russian Heart Failure Journal. 2012;13(1):19-25

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