Abstract 2551: Impact of Left Ventricular Geometry on Mortality in 11,792 Obese Patients With Normal Ejection Fraction
BACKGROUND - Obesity is an independent predictor of left ventricular hypertrophy (LVH) and cardiac events. Although other LV geometric abnormalities, particularly concentric remodeling (CR), also predict cardiac prognosis, the role of obesity (body mass index or BMI ≥ 30 kg/m2) and CR has not been evaluated.
METHODS - We evaluated 11,792 obese patients (57 ± 13 years; BMI 35.8 ± 5.7 kg/m2; 53% female) with ejection fraction (EF) ≥ 50% (60 ± 4.4%) to determine the impact of LV geometry on mortality during a 3-year follow-up. Normal structure = no LVH by LV mass index (LVMI) criteria (LVH = LVMI > 116g/m2 in men > 104 g/m2 in women) and relative wall thickness (RWT) < 0.43; CR = no LVH and RWT ≥ 0.43; eccentric LVH (EH) = LVH and RWT < 0.43 and concentric LVH (CH) = LVH and RWT < 0.43.
RESULTS - (See table⇓). In multivariate analysis, independent predictors of mortality included higher age (Chi-square 198; p < 0.0001), higher RWT (Chi-square 22.0; p < 0.0001), higher BMI (Chi-square 14.4; p = 0.0001), higher LVMI (Chi-square 13.5; p = 0.0002) and male gender (Chi-square 8.9; p = 0.03).
CONCLUSIONS - LV geometric abnormalities are extremely prevalent (49%) in obese with normal EF, with CR being the most prevalent (34%) abnormal pattern. Compared with obese with normal LV structure, progressive significant increases in mortality occur with CR, EH, and CH.