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Vol. 58. Issue 2.
Pages 112-118 (April - June 2023)
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Vol. 58. Issue 2.
Pages 112-118 (April - June 2023)
Artículo original
Valor pronóstico de la hipertrofia ventricular izquierda valorada por voltaje en electrocardiograma en pacientes con síndrome coronario crónico
Prognostic value of left ventricle hypertrophy assessed by the voltage of the electrocardiogram in patients with chronic coronary syndrome
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Alberto Corderoa,b,c,
Corresponding author
acorderofort@gmail.com

Autor para correspondencia.
, David Escribanoa,b, M. Amparo Quintanillaa, José M. López-Ayalaa, José Moreno-Arribasa,b, Elías Martínez Rey-Rañala, Diego Cazorlaa, Vicente Bertomeu-Gonzáleza,b,c, Pilar Zuazolaa
a Departamento de Cardiología, Hospital Universitario San Juan de Alicante, Alicante, España
b Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, España
c Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España
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Tables (2)
Tabla 1. Características de la cohorte en función de la presencia o no de HVI al inicio del seguimiento
Tabla 2. Resultados del estudio multivariante
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Resumen
Introducción y objetivos

La mayoría de los pacientes con síndrome coronario crónico tienen alteraciones en el electrocardiograma y se desconoce el valor pronóstico de la hipertrofia ventricular izquierda (HVI) valorada por criterios de electrocardiograma.

Métodos

Registro retrospectivo de todos los pacientes con síndrome coronario crónico atendidos en una consulta monográfica. Se calculó el índice de Cornell y Sokolov-Lyon, considerándose HVI por voltaje valores> 28 (varones) o> 20 (mujeres) en el primero, y> 35 para el segundo. Durante el seguimiento se evaluó la mortalidad por causa cardiovascular, cualquier causa o eventos adversos cardiovasculares mayores (MACE) considerando reinfarto, insuficiencia cardiaca, accidente cerebrovascular o hemorragia mayor.

Resultados

Se incluyó a 774 pacientes y 60 (8,31%) cumplían criterios de HVI por cualquiera de los criterios. La mediana de seguimiento fue de 960 días [rango intercuartílico 538-1.586] y durante este periodo fallecieron 33 (4,6%) pacientes, 22 (3,1%) atribuibles a causa cardiovascular, y 110 (15,2%) presentaron MACE. En el análisis multivariante, ajustado por edad, sexo, diabetes, tratamiento médico y frecuencia cardiaca, los índices de HVI se asociaron linealmente con mayor riesgo de muerte por cualquier causa (HR = 1,11; IC95%, 1,07-1,16; p> 0,001), por causa cardiovascular (HR=1,11; IC95%, 1,06-1,17; p> 0,001) y MACE (HR=1,04; IC95%, 1,01-1,06; p=0,015). También se encontró un riesgo independiente para HVI.

Conclusiones

La HVI, valorada por criterios de voltaje en el electrocardiograma, tiene un elevado valor predictivo de mortalidad y complicaciones cardiovasculares mayores en pacientes con síndrome coronario crónico.

Palabras clave:
Cornell
Hipertrofia
ECG
Pronóstico
Abreviaturas:
ECG
HVI
MACE
SCA
SCC
Abstract
Introduction and objectives

Most patients with chronic coronary syndrome altered electrocardiogram hypertension, but the prognostic value of left ventricular hypertrophy (LVH) assessed by electrocardiogram criteria is unknown.

Methods

Retrosprospective registry of all patients with chronic coronary syndrome attended in a monographic clinic. We calculated the Cornell index and Sokolov-Lyon index and values> 28 (men) or> 20 (women) were considered for LVH for the first and> 35mm in the second. During follow-up, all-cause or cardiovascular mortality or major cardiovascular events (MACE), considering reinfarction, heart failure, cerebrovascular accident, or major hemorrhage, were evaluated.

Results

A total of 774 patients were included and 60 (8.31%) fulfilled the LVH criteria by the electrocardiogram. The median follow-up was 960 days [interquartile range 538-1586] and during this period 33 (4.6%) patients died, 22 (3.1%) of the deaths were attributable to cardiovascular causes, and 110 (15,2%) patients presented a MACE. In the multivariate analysis, adjusted for age, sex, diabetes, medical treatment and heart rate, both Cornell and Sokolow-Lyon index were linearly associated with a higher risk of death from any cause (HR, 1.11; 95%CI, 1.07-1.16; P> .001), due to cardiovascular causes (HR, 1.11; 95%CI, 1.06-1.17; P> .001) and MACE (HR, 1.04; 95%CI, 1.01-1.06; P=.015). An independent risk was also observed for LVH.

Conclusions

LVH, obtained by electrocardiogram criteria, has a high predictive value for mortality and major cardiovascular complications in patients with chronic coronary syndrome.

Keywords:
Cornell
Hypertrophy
EKG
Prognosis

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