Electrocardiographic Left Ventricular Hypertrophy Is Independently Associated With Better Long-Term Outcomes in Dilated Cardiomyopathy Patients

Shouji Matsushima; Hidetaka Kaku; Nobuyuki Enzan; Tomomi Ide; Taiki Higo; Miyuki Tsuchihashi-Makaya; Hiroyuki Tsutsui

doi:10.1253/circrep.CR-19-0025

Electrocardiographic Left Ventricular Hypertrophy Is Independently Associated With Better Long-Term Outcomes in Dilated Cardiomyopathy Patients

Circ Rep. 2019 May 30;1(6):248-254. doi: 10.1253/circrep.CR-19-0025.

Authors

Shouji Matsushima¹, Hidetaka Kaku², Nobuyuki Enzan², Tomomi Ide³, Taiki Higo¹, Miyuki Tsuchihashi-Makaya⁴, Hiroyuki Tsutsui²

Affiliations

¹ Department of Cardiovascular Medicine, Kyushu University Hospital Fukuoka Japan.
² Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Fukuoka Japan.
³ Department of Experimental and Clinical Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Fukuoka Japan.
⁴ School of Nursing, Kitasato University Tokyo Japan.

Abstract

Background: Electrocardiogram (ECG) findings of left ventricular hypertrophy (LVH; ECG-LVH) are observed in patients with dilated cardiomyopathy (DCM), but the prognostic importance is unclear. The present study assessed the impact of QRS voltage on long-term outcomes, including mortality and rehospitalization, in patients with DCM using a database of patients hospitalized for worsening heart failure (HF). Methods and Results: We analyzed a total of 261 patients with DCM in the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD), a prospective cohort studying the characteristics and treatments in a broad sample of HF patients. ECG-LVH were diagnosed according to the Sokolow-Lyon voltage criteria. A total of 81 patients (31.0%) had ECG-LVH. During a mean follow-up period of 1.8 years, patients with ECG-LVH had a lower rate of all-cause death (9.0% vs. 20.3%, P=0.029) and composite of all-cause death and rehospitalization due to worsening HF (26.9% vs. 45.9%, P=0.007) than those without it. After multivariable adjustment, ECG-LVH was an independent negative predictor for the risk of composite all-cause death and rehospitalization (hazard ratio, 0.358; 95% CI: 0.157-0.857, P=0.049). Conclusions: ECG-LVH were independently associated with better long-term outcome in patients with DCM.

Keywords: Dilated cardiomyopathy; Left ventricular hypertrophy; Outcome; QRS voltage.