在普通人群中，心电图左心室肥厚对女性发生心血管事件来说，是比男性更强的危险因素。

ECG left ventricular hypertrophy is a stronger risk factor for incident cardiovascular events in women than in men in the general population.

作者信息

Porthan Kimmo, Niiranen Teemu J, Varis Juha, Kantola Ilkka, Karanko Hannu, Kähönen Mika, Nieminen Markku S, Salomaa Veikko, Huikuri Heikki V, Jula Antti M

机构信息

aDivision of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki bDivision of Medicine, Turku University Hospital, Turku cDepartment of Health, National Institute for Health and Welfare, Turku/Helsinki dDepartment of Clinical Physiology, University of Tampere eTampere University Hospital, Tampere fInstitute of Clinical Medicine, University of Oulu and University Central Hospital of Oulu, Oulu, Finland.

出版信息

J Hypertens. 2015 Jun;33(6):1284-90. doi: 10.1097/HJH.0000000000000553.

DOI:10.1097/HJH.0000000000000553

PMID:25764049

Abstract

OBJECTIVE

Left ventricular hypertrophy (LVH) is a strong risk factor for cardiovascular events. ECG is the most widely used method for LVH detection. Despite the abundance of ECG LVH criteria, their prognostic values have been compared in only a few studies, and little has been known about how sex modifies the prognostic value of LVH. We assessed the relationship between ECG LVH and incident cardiovascular events in the general population.

METHODS

Several ECG LVH criteria were measured in 3059 women and 2456 men participating in the Health 2000 Study - a national general population survey. Association between ECG LVH and cardiovascular events were analyzed with Cox proportional-hazards models.

RESULTS

ECG LVH was more prevalent in women than in men when measured with Cornell-based criteria, but less prevalent or nondifferent when measured with other criteria. The association between ECG LVH and events showed higher hazard ratios for women than in men. Sex × LVH interaction terms were statistically significant in part of the LVH criteria. In adjusted Cox models, Sokolow-Lyon voltage performed the best. The composite of Sokolow-Lyon voltage and Cornell voltage was statistically significantly associated with events in both sexes.

CONCLUSION

Sex affects both the prevalence rates and prognostic values of ECG LVH criteria in the general population, while showing higher prognostic value of ECG LVH in women than in men. For clinical use, the composite of the Sokolow-Lyon voltage and the Cornell voltage seems to be a good option.

摘要

目的

左心室肥厚（LVH）是心血管事件的一个重要危险因素。心电图是检测LVH最广泛使用的方法。尽管有大量的心电图LVH诊断标准，但只有少数研究对它们的预后价值进行了比较，而且对于性别如何影响LVH的预后价值知之甚少。我们评估了普通人群中心电图LVH与心血管事件发生之间的关系。

方法

在参与“健康2000研究”（一项全国性普通人群调查）的3059名女性和2456名男性中测量了几种心电图LVH标准。采用Cox比例风险模型分析心电图LVH与心血管事件之间的关联。

结果

以基于康奈尔标准测量时，心电图LVH在女性中比在男性中更常见，但以其他标准测量时则较少见或无差异。心电图LVH与事件之间的关联显示女性的风险比高于男性。在部分LVH标准中，性别×LVH交互项具有统计学意义。在调整后的Cox模型中，索科洛-里昂电压表现最佳。索科洛-里昂电压和康奈尔电压的综合指标在两性中均与事件有统计学显著关联。