Kenneth S. Schwartz

Usefulness of echocardiographic left ventricular hypertrophy, ventricular tachycardia and complex ventricular arrhythmias in predicting ventricular fibrillation or sudden cardiac death in elderly patients

Abstract Echocardiographic left ventricular (LV) hypertrophy is associated with an increased incidence of new coronary events. 1–3 Ventricular tachycardia (VT) and complex ventricular arrhythmias associated with heart disease are independent risk factors for new cardiac events in elderly patients. 4 We reported in a prospective study that VT was present in 30 of 196 elderly patients (15%) with echocardiographic LV hypertrophy and in 23 of 358 patients (6%) without LV hypertrophy (p 5 Complex ventricular arrhythmias occurred in 147 of 196 patients (75%) with LV hypertrophy and in 157 of 358 patients (44%) without LV hypertrophy (p 5 We are now reporting 27-month follow-up data correlating LV hypertrophy, VT and complex ventricular arrhythmias with development of primary ventricular fibrillation (VF) or sudden cardiac death in these 554 unselected patients older than 62 years in a long-term health care facility.

Usefulness of echocardiographic left ventricular hypertrophy in predicting new coronary events and atherothrombotic brain infarction in patients over 62 years of age

Abstract Patients with electrocardiographic left ventricular (LV) hypertrophy have an increased risk of cardiovascular morbidity and mortality. 1−5 Echocardiography is more sensitive and more specific than electrocardiography in detecting LV hypertrophy. 6−8 We performed a prospective study to correlate echocardiographic LV hypertrophy with development of new cardiac events and atherothrombotic brain infarction (ABI) in unselected patients older than 62 years.

Correlation of serum lipids, calcium and phosphorus, diabetes mellitus, aortic valve stenosis and history of systemic hypertension with presence or absence of mitral anular calcium in persons older than 62 years in a long-term health care facility.

Abstract Mitral anular calcium (MAC) is a degenerative process common in elderly patients. 1–6 Roberts and colleagues 1,2 suggested that MAC is accelerated by conditions that increase left ventricular pressure and by conditions that accelerate atherosclerosis. Nair et al 4 reported that patients with MAC had a higher level of serum phosphorus and product of serum calcium and phosphorus and an increased prevalence of systemic hypertension and diabetes mellitus than a control group. During a blinded, prospective study of the prevalence of MAC in an unselected population of persons older than 62 years in a long-term health care facility, we obtained data to correlate serum total cholesterol, high-density lipoprotein cholesterol, triglycerides, calcium, phosphorus, and product of calcium and phosphorus, diabetes mellitus, aortic valve stenosis and history of systemic hypertension with the presence or absence of MAC.

Correlation of complex ventricular arrhythmias detected by ambulatory electrocardiographic monitoring with echocardiographic left ventricular hypertrophy in persons older than 62 years in a long-term health care facility

Abstract The incidence of cardiovascular morbid events is higher in patients with left ventricular (LV) hypertrophy detected by electrocardiography than in those without LV hypertrophy. 1 Hypertensive patients with electrocardiographic LV hypertrophy have more frequent and complex ventricular premature complexes (VPCs) than those without LV hypertrophy. 2 Echocardiography has a greater sensitivity, specificity, positive predictive value and negative predictive value than electrocardiography in diagnosing LV hypertrophy. 3 We performed a prospective study to correlate the prevalence of complex ventricular arrhythmias detected by ambulatory electrocardiographic monitoring with increased LV mass detected by technically adequate M-mode and 2-dimensional echocardiograms in unselected persons older than 62 years in a long-term health care facility.

Usefulness of echocardiographic abnormal left ventricular ejection fraction, paroxysmal ventricular tachycardia and complex ventricular arrhythmias in predicting new coronary events in patients over 62 years of age.

Abstract Patients with an abnormal left ventricular (LV) ejection fraction (EF), with paroxysmal ventricular tachycardia (VT) or with complex ventricular arrhythmias associated with heart disease are at increased risk for cardiac events. 1–9 We previously reported the prevalence of an abnormal LVEF determined by M-mode and 2-dimensional echocardiography and the prevalence of VT and complex ventricular arrhythmias detected by 24-hour ambulatory electrocardiographic recordings in unselected patients older than 62 years in a long-term health care facility. 10 In the present report we present the results from a prospective study correlating abnormal LVEF, VT and complex ventricular arrhythmias with development of cardiac events at 2-year follow-up in 467 unselected patients older than 62 years.

Correlation of aortic cuspal and aortic root disease with aortic systolic ejection murmurs and with mitral anular calcium in persons older than 62 years in a long-term health care facility

Abstract Aortic systolic ejection murmurs (ASM) are common in elderly persons. 1,2 Calcific deposits in the aortic valve are common in elderly persons and may lead to aortic stenosis. 2,3 Calcific deposits in the aortic valve occurred in 22 of 40 necropsy patients (55%) aged 90 to 103 years. 3 Calcium of the aortic valve and mitral anulus (MAC) may coexist. 2–5 In addition, aortic cuspal or root thickening (aortic sclerosis) may cause ASM in elderly persons. 6 We performed this prospective study to determine the prevalence of ASM, calcified aortic cusps, aortic stenosis and aortic sclerosis, and the correlation of calcified aortic cusps, aortic stenosis and aortic sclerosis with ASM and with MAC in an unselected population of elderly persons older than 62 years in a long-term health care facility.

Correlation of atrial fibrillation with presence or absence of mitral anular calcium in 604 persons older than 60 years

Abstract Savage et al 1 reported a 12-fold increase in atrial fibrillation (AF) in persons with mitral anular calcium (MAC) in the Framingham Study. During a blinded, prospective study investigating the prevalence of MAC diagnosed by M-mode and 2-dimensional echo-cardiograms in an unselected population older than 62 years in a long-term health care facility, 2,3 we recorded electrocardiograms to determine the prevalence of AF and its correlation with the presence or absence of MAC.

Prevalence of arrhythmias detected by ambulatory electrocardiographic monitoring and of abnormal left ventricular ejection fraction in persons older than 62 years in a long-term health care facility

Abstract The prevalence of arrhythmias detected by ambulatory electrocardiographic (ECG) monitoring in healthy elderly or active elderly persons has been reported in studies involving 13 to 106 persons. 1–4 We performed a prospective study to determine the prevalence of arrhythmias detected by ambulatory ECG monitoring in unselected persons older than 62 years in a long-term health care facility who had technically adequate M-mode and 2-dimensional echocardiograms for measuring left ventricular (LV) ejection fraction (EF).

Usefulness of echocardiographic and electrocardiographic left ventricular hypertrophy in predicting new cardiac events and atherothrombotic brain infarction in elderly patients with systemic hypertension or coronary artery disease

We performed a prospective study to correlate echocardiographic and electrocardiographic left ventricular (LV) hypertrophy with new cardiac events and atherothrombotic brain infarction (ABI) in 360 elderly patients with hypertension or coronary artery disease. The mean follow-up was 37±7 months (range 20-4 − )