Development and validation of a clinical score to identify echo cardiographic left ventricular hypertrophy in patients with cardiovascular disease

Donald S. C. Ang, Tom P. Fahey, Gary A. Wright, Allan D. Struthers

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    BACKGROUND

    Echocardiographic (echo) left ventricular hypertrophy (LVH) is an independent predictor of mortality. Despite this, screening for LVH in patients with overt cardiovascular diseases is not universally done. To help target echo screening for LVH in patient population, we developed and validated a simple clinical score to help identify those likely to have echo LVH.

    METHODS

    We performed two studies. The development cohort consisted of 267 patients with angina. The validation cohort consisted of 227 patients with peripheral arterial disease.

    RESULTS

    The prevalence of echo LVH in both patient cohorts was 50%. Six independent predictors of LVH were identified in the development cohort: age >65 years (1 point), body mass index >30 kg/m(2) (1 point), history of hypertension (1 point), previous myocardial infarction (1 point), clinic blood pressure >130/80 mm Hg (1 point) and bundle branch block (BBB) on electrocardiogram (4 points). Our clinical score was strongly associated with the presence of LVH in the validation cohort. It also showed a significant continuous positive relationship (P trend <0.001 in males and P trend = 0.006 in females) with increasing quartiles of LV mass in both cohorts. In those without BBB, a modified clinical score performed equally well.

    CONCLUSION

    We have developed a simple clinical score which quantifies the chance that any patient with manifest cardiovascular disease has the added risk factor of LVH. This will help target precious echo resources toward individuals who are most likely to have this condition. This could potentially lead to better risk stratification in this patient population.

    Original languageEnglish
    Pages (from-to)1011-1017
    Number of pages7
    JournalAmerican Journal of Hypertension
    Volume21
    Issue number9
    DOIs
    Publication statusPublished - 2008

    Keywords

    • CORONARY-ARTERY DISEASE
    • BUNDLE-BRANCH BLOCK
    • ESSENTIAL-HYPERTENSION
    • PROGNOSTIC INDEX
    • OLDER-ADULTS
    • HEART
    • POPULATION
    • CRITERIA
    • PREVALENCE
    • MORBIDITY

    Cite this

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    title = "Development and validation of a clinical score to identify echo cardiographic left ventricular hypertrophy in patients with cardiovascular disease",
    abstract = "BACKGROUNDEchocardiographic (echo) left ventricular hypertrophy (LVH) is an independent predictor of mortality. Despite this, screening for LVH in patients with overt cardiovascular diseases is not universally done. To help target echo screening for LVH in patient population, we developed and validated a simple clinical score to help identify those likely to have echo LVH.METHODSWe performed two studies. The development cohort consisted of 267 patients with angina. The validation cohort consisted of 227 patients with peripheral arterial disease.RESULTSThe prevalence of echo LVH in both patient cohorts was 50{\%}. Six independent predictors of LVH were identified in the development cohort: age >65 years (1 point), body mass index >30 kg/m(2) (1 point), history of hypertension (1 point), previous myocardial infarction (1 point), clinic blood pressure >130/80 mm Hg (1 point) and bundle branch block (BBB) on electrocardiogram (4 points). Our clinical score was strongly associated with the presence of LVH in the validation cohort. It also showed a significant continuous positive relationship (P trend <0.001 in males and P trend = 0.006 in females) with increasing quartiles of LV mass in both cohorts. In those without BBB, a modified clinical score performed equally well.CONCLUSIONWe have developed a simple clinical score which quantifies the chance that any patient with manifest cardiovascular disease has the added risk factor of LVH. This will help target precious echo resources toward individuals who are most likely to have this condition. This could potentially lead to better risk stratification in this patient population.",
    keywords = "CORONARY-ARTERY DISEASE, BUNDLE-BRANCH BLOCK, ESSENTIAL-HYPERTENSION, PROGNOSTIC INDEX, OLDER-ADULTS, HEART, POPULATION, CRITERIA, PREVALENCE, MORBIDITY",
    author = "Ang, {Donald S. C.} and Fahey, {Tom P.} and Wright, {Gary A.} and Struthers, {Allan D.}",
    year = "2008",
    doi = "10.1038/ajh.2008.236",
    language = "English",
    volume = "21",
    pages = "1011--1017",
    journal = "American Journal of Hypertension",
    issn = "0895-7061",
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    }

    Development and validation of a clinical score to identify echo cardiographic left ventricular hypertrophy in patients with cardiovascular disease. / Ang, Donald S. C.; Fahey, Tom P.; Wright, Gary A.; Struthers, Allan D.

    In: American Journal of Hypertension, Vol. 21, No. 9, 2008, p. 1011-1017.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Development and validation of a clinical score to identify echo cardiographic left ventricular hypertrophy in patients with cardiovascular disease

    AU - Ang, Donald S. C.

    AU - Fahey, Tom P.

    AU - Wright, Gary A.

    AU - Struthers, Allan D.

    PY - 2008

    Y1 - 2008

    N2 - BACKGROUNDEchocardiographic (echo) left ventricular hypertrophy (LVH) is an independent predictor of mortality. Despite this, screening for LVH in patients with overt cardiovascular diseases is not universally done. To help target echo screening for LVH in patient population, we developed and validated a simple clinical score to help identify those likely to have echo LVH.METHODSWe performed two studies. The development cohort consisted of 267 patients with angina. The validation cohort consisted of 227 patients with peripheral arterial disease.RESULTSThe prevalence of echo LVH in both patient cohorts was 50%. Six independent predictors of LVH were identified in the development cohort: age >65 years (1 point), body mass index >30 kg/m(2) (1 point), history of hypertension (1 point), previous myocardial infarction (1 point), clinic blood pressure >130/80 mm Hg (1 point) and bundle branch block (BBB) on electrocardiogram (4 points). Our clinical score was strongly associated with the presence of LVH in the validation cohort. It also showed a significant continuous positive relationship (P trend <0.001 in males and P trend = 0.006 in females) with increasing quartiles of LV mass in both cohorts. In those without BBB, a modified clinical score performed equally well.CONCLUSIONWe have developed a simple clinical score which quantifies the chance that any patient with manifest cardiovascular disease has the added risk factor of LVH. This will help target precious echo resources toward individuals who are most likely to have this condition. This could potentially lead to better risk stratification in this patient population.

    AB - BACKGROUNDEchocardiographic (echo) left ventricular hypertrophy (LVH) is an independent predictor of mortality. Despite this, screening for LVH in patients with overt cardiovascular diseases is not universally done. To help target echo screening for LVH in patient population, we developed and validated a simple clinical score to help identify those likely to have echo LVH.METHODSWe performed two studies. The development cohort consisted of 267 patients with angina. The validation cohort consisted of 227 patients with peripheral arterial disease.RESULTSThe prevalence of echo LVH in both patient cohorts was 50%. Six independent predictors of LVH were identified in the development cohort: age >65 years (1 point), body mass index >30 kg/m(2) (1 point), history of hypertension (1 point), previous myocardial infarction (1 point), clinic blood pressure >130/80 mm Hg (1 point) and bundle branch block (BBB) on electrocardiogram (4 points). Our clinical score was strongly associated with the presence of LVH in the validation cohort. It also showed a significant continuous positive relationship (P trend <0.001 in males and P trend = 0.006 in females) with increasing quartiles of LV mass in both cohorts. In those without BBB, a modified clinical score performed equally well.CONCLUSIONWe have developed a simple clinical score which quantifies the chance that any patient with manifest cardiovascular disease has the added risk factor of LVH. This will help target precious echo resources toward individuals who are most likely to have this condition. This could potentially lead to better risk stratification in this patient population.

    KW - CORONARY-ARTERY DISEASE

    KW - BUNDLE-BRANCH BLOCK

    KW - ESSENTIAL-HYPERTENSION

    KW - PROGNOSTIC INDEX

    KW - OLDER-ADULTS

    KW - HEART

    KW - POPULATION

    KW - CRITERIA

    KW - PREVALENCE

    KW - MORBIDITY

    U2 - 10.1038/ajh.2008.236

    DO - 10.1038/ajh.2008.236

    M3 - Article

    VL - 21

    SP - 1011

    EP - 1017

    JO - American Journal of Hypertension

    JF - American Journal of Hypertension

    SN - 0895-7061

    IS - 9

    ER -