Aronow W S, Ahn C
Hebrew Hospital Home, Bronx, New York 10475, USA.
J Am Geriatr Soc. 1998 Oct;46(10):1280-1. doi: 10.1111/j.1532-5415.1998.tb04546.x.
To investigate the association of electrocardiographic (ECG) left ventricular hypertrophy (LVH) with the incidence of new congestive heart failure (CHF) in older people.
In a prospective study of 2638 older people, ECGs were obtained at study entry, at 1 month after study entry, when clinically indicated, and at least yearly after study entry. ECG LVH was diagnosed if the point score of Romhilt and Estes was > or = 5. Persistent LVH was diagnosed if all of the ECGs showed LVH. New LVH was diagnosed if the baseline ECG showed no LVH but LVH was present on the last ECG. Regression of LVH was diagnosed if the baseline ECG showed LVH but no LVH was present on the last ECG. No LVH was diagnosed if all of the ECGs showed no LVH. Persistent LVH, new LVH, regression of LVH, and no LVH were correlated with the incidence of new CHF at follow-up.
A large long-term health care facility.
The patients included 1805 women and 833 men, mean age 81 +/- 9 years (range 60 to 103).
Of the 2,638 older persons studied, 281 (11%) had persistent ECG LVH, 31 (1%) had new ECG LVH, 12 (0.5%) had regression of ECG LVH, and 2314 (88%) had no ECG LVH. At 42 +/- 24 months (range 1 to 154 months) follow-up, new CHF developed in 168 of 281 persons (60%) with persistent LVH, in 16 of 31 persons (52%) with new LVH, in 4 of 12 persons (33%) with regression of LVH, and in 507 of 2314 persons (22%) with no LVH. Kaplan-Meier survival curves showed that the development of new CHF was higher in persons with persistent LVH versus regression of LVH (P = .013), in persons with persistent LVH versus no LVH (P = .001), in persons with new LVH versus regression of LVH (P = .039), and in persons with new LVH versus no LVH (P = .001).
Older persons with persistent or new ECG LVH have a higher incidence of new CHF and an earlier time to the development of new CHF than older persons without ECG LVH.
研究老年人心电图（ECG）左心室肥厚（LVH）与新发充血性心力衰竭（CHF）发生率之间的关联。
在一项对2638名老年人的前瞻性研究中，在研究开始时、研究开始后1个月、临床需要时以及研究开始后至少每年进行一次心电图检查。如果Romhilt和Estes评分≥5分，则诊断为ECG左心室肥厚。如果所有心电图均显示左心室肥厚，则诊断为持续性左心室肥厚。如果基线心电图未显示左心室肥厚但最后一次心电图显示有左心室肥厚，则诊断为新发左心室肥厚。如果基线心电图显示左心室肥厚但最后一次心电图未显示左心室肥厚，则诊断为左心室肥厚消退。如果所有心电图均未显示左心室肥厚，则诊断为无左心室肥厚。将持续性左心室肥厚、新发左心室肥厚、左心室肥厚消退和无左心室肥厚与随访时新发CHF的发生率进行关联分析。
一家大型长期医疗保健机构。
患者包括1805名女性和833名男性，平均年龄81±9岁（范围60至103岁）。
在研究的2638名老年人中，281人（11%）有持续性ECG左心室肥厚，31人（1%）有新发ECG左心室肥厚，12人（0.5%）有ECG左心室肥厚消退，2314人（88%）无ECG左心室肥厚。在42±24个月（范围1至154个月）的随访中，281名持续性左心室肥厚患者中有168人（60%）发生了新发CHF，31名新发左心室肥厚患者中有16人（52%）发生了新发CHF，12名左心室肥厚消退患者中有4人（33%）发生了新发CHF，2314名无左心室肥厚患者中有507人（22%）发生了新发CHF。Kaplan-Meier生存曲线显示，持续性左心室肥厚患者与左心室肥厚消退患者相比，新发CHF的发生率更高（P = 0.013）；持续性左心室肥厚患者与无左心室肥厚患者相比，新发CHF的发生率更高（P = 0.001）；新发左心室肥厚患者与左心室肥厚消退患者相比，新发CHF的发生率更高（P = 0.039）；新发左心室肥厚患者与无左心室肥厚患者相比，新发CHF的发生率更高（P = 0.001）。
与无ECG左心室肥厚的老年人相比，有持续性或新发ECG左心室肥厚的老年人新发CHF的发生率更高，且新发CHF的发生时间更早。
