University of Oulu

Haukilahti, M. A. E., Kenttä, T. V., Tikkanen, J. T., Anttonen, O., Aro, A. L., Kerola, T., Rissanen, H., Knekt, P., Junttila, M. J., & Huikuri, H. V. (2020). Electrocardiographic Risk Markers for Heart Failure in Women Versus Men. The American Journal of Cardiology, 130, 70–77.

Electrocardiographic risk markers for heart failure in women versus men

Saved in:
Author: Haukilahti, Mira Anette E.1; Kenttä, Tuomas V.1; Tikkanen, Jani T.1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Finland
2Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
3Division of Cardiology Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
4Finnish National Institute for Health and Welfare, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: Elsevier, 2020
Publish Date: 2021-06-17


Heart failure (HF) is one of the leading causes of hospitalization in the Western world. Women have a lower HF hospitalization rate and mortality compared with men. The role of electrocardiography as a risk marker of future HF in women is not well known. We studied association of electrocardiographic (ECG) risk factors for HF hospitalization in women from a large middle-aged general population with a long-term follow-up and compared the risk profile to men. Standard 12-lead ECG markers were analyzed from 10,864 subjects (49% women), and their predictive value for HF hospitalization was analyzed. During the follow-up (30 ± 11 years), a total of 1,743 subjects had HF hospitalization; of these, 861 were women (49%). Several baseline characteristics, such as age, body mass index, blood pressure, and history of previous cardiac disease predicted the occurrence of HF both in women and men (p <0.001 for all). After adjusting for baseline variables, ECG sign of left ventricular hypertrophy (LVH) (p <0.001), and atrial fibrillation (p <0.001) were the only baseline ECG variables that predicted future HF in women. In men, HF was predicted by fast heart rate (p = 0.008), T wave inversions (p <0.001), abnormal Q-waves (p = 0.002), and atrial fibrillation (p <0.001). Statistically significant gender interactions in prediction of HF were observed in ECG sign of LVH, inferolateral T wave inversions, and heart rate. In conclusion, ECG sign of LVH predicts future HF in middle-aged women, and T wave inversions and elevated heart rate are associated with HF hospitalization in men.

see all

Series: The American journal of cardiology
ISSN: 0002-9149
ISSN-E: 1879-1913
ISSN-L: 0002-9149
Volume: 130
Pages: 70 - 77
DOI: 10.1016/j.amjcard.2020.06.018
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study has been carried out in collaboration with National Institute for Health and Welfare and supported in part by Sigrid Juselius Foundation, Helsinki, Finland (HH, JT, AA), Finnish Medical Foundation, Helsinki, Finland (AA, AH), Instrumentarium Science Foundation, Helsinki, Finland (JT), Juho Vainio Foundation (AH), Helsinki, Finland, Maud Kuistila Memorial Foundation, Helsinki, Finland (AH), Finnish Foundation for cardiovascular Research, Helsinki, Finland (AH), Paulo Foundation, Espoo, Finland (AH), Aarne Koskelo Foundation, Helsinki, Finland (AH), Päivikki and Sakari Sohlberg Foundation, Helsinki, Finland (AH).
Copyright information: © 2020 Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http:/