Left ventricular hypertrophy findings on ECG predicts impaired left
atrial functions
Abstract
Background: Electrocardiographic left ventricular hypertrophy
(ECG LVH) has a prognostic value for cardiovascular diseases.
Pathological processes that cause development of left ventricular
hypertrophy (LVH) also leads to remodeling and dysfunction of the left
atrium (LA). Atrial functions can be evaluated by 2D speckle tracking
echocardiography. In our study, we aimed to investigate whether the ECG
LVH is associated with left atrial strain. Methods: Sixty two
patients with LVH according to echocardiographic left ventricle mass
index were included in the study. ECG LVH was defined according to:
Sokolow- Lyon voltage
SV1+RV5/RV6>35mm;
Cornell voltage RaVL+SV3>28
mm (for men) >20mm (for women); or Cornell product
(SV3+RAVL+(for women 8 mm)) x QRS
duration)>2440 mmxms criteria. Patients were categorised
into two groups according to presence or absence of ECG LVH. Association
between left atrial strain values and ECG findings were evaluated.
Results: The mean age of the patients were 58.3±10.1 years;
40.3% were women; 91,9% had hypertension; 35.5% had diabetes.
Nineteen patients (30.6%) had ECG LVH according to Sokolow-Lyon
voltage, Cornell voltage or Cornell product. Left atrial reservoir,
conduit and contraction strains were significantly lower in patients
with ECG LVH (p<0.001). Additionally, there was statistically
significant correlation between all three phases of left atrial strain
values and presence of Sokolow-Lyon voltage (reservoir phase r:-0.389
p<0.01; conduit phase, r:-0.273 p<0.05; contraction
phase r:-0.359 p<0.01) Cornell voltage (reservoir phase
r:-0.49 p<0.001; conduit phase r:-0.432 p<0.001;
contraction phase r:-0. 339 p<0.01) Cornell product (reservoir
phase r:-0.471 p<0.001; conduit phase r:-0.387
p<0.01; contraction phase r:-0.362 p<0.01).
Conclusion: ECG LVH was associated with left atrial strain and
therefore it can be a useful tool to predict left atrial dysfunction.