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<p>The relationship between left ventricular hypertrophy (LVH) and prognosis in hypertensive individuals has been reported, but the prognostic value of electrocardiographic LVH (ECG-LVH) in the presence or absence of chronic kidney disease (CKD) remains unclear. We retrospectively analyzed 697 hypertensive patients enrolled in the Japan Morning Surge Home Blood Pressure study. ECG-LVH was evaluated using the Sokolow–Lyon voltage (SL), Cornell product (CP), and RV5/V6 criteria, defined as the upper quartile. Echocardiographic LVH (echo-LVH) was defined as a left ventricular mass index &gt;115 g/m² in men and &gt;95 g/m² in women. The primary endpoint was a composite of major cardiovascular events. For predicting echo-LVH, sensitivities and specificities without CKD were 22% and 85% for SL, 40% and 83% for CP, and 31% and 76% for RV5/V6; with CKD, they were 23% and 90% for SL, 54% and 84% for CP, and 25% and 82% for RV5/V6. During a mean follow-up of 100 months, 76 primary events occurred. In Cox proportional hazards models adjusted for covariates, ECG-LVH in the patients without CKD was associated with hazard ratios (HRs) of 1.72 (95% CI: 0.91–3.26) for SL, 1.10 (0.57–2.12) for CP, and 0.96 (0.52–1.75) for RV5/V6. In the patients with CKD, the HRs were 3.08 (1.28–7.41) for SL, 0.90 (0.37–2.21) for CP, and 2.03 (0.82–5.02) for RV5/V6. The SL criterion was useful for predicting prognosis in hypertensive patients with CKD, although its sensitivity for the diagnosis of LVH was limited.</p><p></p>

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Association of electrocardiographic left ventricular hypertrophy with cardiovascular events in hypertensive patients with and without chronic kidney disease

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Kei Takahashi,
  • Tomoyuki Kabutoya,
  • Satoshi Hoshide,
  • Kazuomi Kario

摘要

The relationship between left ventricular hypertrophy (LVH) and prognosis in hypertensive individuals has been reported, but the prognostic value of electrocardiographic LVH (ECG-LVH) in the presence or absence of chronic kidney disease (CKD) remains unclear. We retrospectively analyzed 697 hypertensive patients enrolled in the Japan Morning Surge Home Blood Pressure study. ECG-LVH was evaluated using the Sokolow–Lyon voltage (SL), Cornell product (CP), and RV5/V6 criteria, defined as the upper quartile. Echocardiographic LVH (echo-LVH) was defined as a left ventricular mass index >115 g/m² in men and >95 g/m² in women. The primary endpoint was a composite of major cardiovascular events. For predicting echo-LVH, sensitivities and specificities without CKD were 22% and 85% for SL, 40% and 83% for CP, and 31% and 76% for RV5/V6; with CKD, they were 23% and 90% for SL, 54% and 84% for CP, and 25% and 82% for RV5/V6. During a mean follow-up of 100 months, 76 primary events occurred. In Cox proportional hazards models adjusted for covariates, ECG-LVH in the patients without CKD was associated with hazard ratios (HRs) of 1.72 (95% CI: 0.91–3.26) for SL, 1.10 (0.57–2.12) for CP, and 0.96 (0.52–1.75) for RV5/V6. In the patients with CKD, the HRs were 3.08 (1.28–7.41) for SL, 0.90 (0.37–2.21) for CP, and 2.03 (0.82–5.02) for RV5/V6. The SL criterion was useful for predicting prognosis in hypertensive patients with CKD, although its sensitivity for the diagnosis of LVH was limited.