Abstract 9398: Cornell Product Criteria for Left Ventricular Hypertrophy Strongly Predicts the Presence of Diastolic Dysfunction

Abstract

Background: Abnormal left ventricular (LV) diastolic function is a known predictor of poor cardiovascular outcomes. Although ECG LV hypertrophy (LVH) has been related to LV systolic dysfunction and both prevalent and incident heart failure, whether ECG LVH is associated with LV diastolic dysfunction (DD) is unknown. Methods: From a cohort of patients who underwent both cardiac computed tomographic angiography and transthoracic echocardiography (TTE) with complete evaluation of diastolic function, 185 that underwent ECG within one year of TTE were identified as the study group. The presence of DD was determined according to standard guidelines via evaluation of mitral inflow velocities, tissue Doppler imaging, deceleration time, isovolumic relaxation time, pulmonary venous systolic: diastolic ratio, and left atrial enlargement. ECG LVH by Cornell product (CP) criteria was categorized into the highest quartile (≥1595 mm[[Unable to Display Character: ⋅]]ms) vs the lower three quartiles or evaluated as a continuous variable with odds ratios (OR) calculated for each SD of the mean (664 mm[[Unable to Display Character: ⋅]]ms) higher CP. Results: Among the 185 patients (56.2% female, mean age 54.6 ± 15.6), mean CP was 1240 ± 664 mm[[Unable to Display Character: ⋅]]ms and 105 (57%) had DD. In univariate logistic regression analysis, being in the upper quartile of CP was associated with over fivefold greater odds of DD (OR 5.1 95% CI 2.2-11.7, p<0.001). In alternative analyses treating CP as a continuous variable, each 1 SD increase in CP was associated with an OR of 1.9 for DD (95% CI 1.3-2.7 p<0.001). In multivariate logistic regression analyses adjusting for statistically significant univariate predictors of DD including age, history of hypertension, hypercholesterolemia, indexed LV mass, R wave axis, degree of coronary artery disease, PR interval and ST segment deviation as covariates, the highest quartile of CP remained associated with a significantly increased odds of having DD (OR 5.7 95% CI 2.2-14.7 p=0.001); alternatively, each 1 SD of CP was associated with a 1.8-fold increased odds of DD (95% CI 1.2-2.5 p=0.003). Conclusions: Cornell product ECG LVH is a powerful predictor of the presence of diastolic dysfunction, even after adjustment for potential confounding risk factors and ECG variables.