In:
European Journal of Clinical Investigation, Wiley, Vol. 44, No. 10 ( 2014-10), p. 893-901
Abstract:
A new 4‐tired classification of left ventricular hypertrophy ( LVH ) based on LV concentricity and dilation has been proposed; however, the association between the new categorization of LV geometry and outcomes in patients with coronary artery disease ( CAD ) is still unknown. Methods All the 2297 patients with CAD included underwent echocardiographic examination prior to discharge. Left ventricular mass ( LVM ) was calculated, and left ventricular end‐diastolic volume ( EDV ) was indexed by body surface area ( BSA ). Study cohort was divided into five groups according to LV geometry: (i) eccentric nondilated LVH (normal LVM / EDV (2/3) and EDV / BSA ) ( n = 129); (ii) eccentric dilated LVH (normal LVM / EDV (2/3) with increased EDV / BSA ) ( n = 222); (iii) concentric nondilated LVH (increased LVM / EDV (2/3) with normal EDV / BSA ) ( n = 441); (iv) concentric dilated LVH (increased LVM / EDV (2/3) and EDV / BSA ) ( n = 118); and (v) normal LV mass ( n = 1387). Results Dilated LVH was associated with a higher event rates of all‐cause death (eccentric 13·1% vs. 3·1%; concentric 13·6% vs. 8·4%) and composite events (eccentric: 17·6% vs. 5·4%; concentric: 18·6% vs. 12·7%) compared with nondilated LVH. While eccentric nondilated LVH had comparable risk for adverse outcomes compared with normal LV mass (all‐cause death: relative risk ( RR ) 0·68, 95% confidential interval ( CI ) 0·25–1·85; composite events: RR 0·75, 95% CI 0·36–1·58). Cox regression analyses showed that eccentric dilated LVH had the highest propensity to all‐cause death (adjusted hazard ratio [ aHR ] 2·752 [95% CI 1·749–4·328], P 〈 0·001) and composite events ( aHR 2·462 [95% CI 1·688–3·592], P 〈 0·001). Conclusion In patients with CAD , dilated LVH and nondilated LVH provide distinct prognostic information. Eccentric nondilated LVH does not predict adverse outcomes.
Type of Medium:
Online Resource
ISSN:
0014-2972
,
1365-2362
DOI:
10.1111/eci.2014.44.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2004971-7
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