Abstract 5416: Exaggerated Mortality Risk in Patients With Severe Left Ventricular Hypertrophy
Introduction: Mild to moderate left ventricular hypertrophy (LVH) has been identified as an independent predictor of increased mortality, but information in patients with severe or very severe LVH is scarce. Thus, we assessed the mortality risk associated with the severity of LVH in a large cohort of male veterans.
Methods: From January of 1993 to March 2009, we identified 11,578 patients (mean age: 68±14) with a technically interpretable baseline echocardiogram at the Veterans Affairs Medical Center, Washington, DC. We calculated left ventricular mass index (LVMI) and classified patients as follows: No-LVH (LVMI <125 g/m2; n=6,835); Mild-Moderate-LVH (LVMI 125–160 g/m2; n=2,673); Severe-LVH (LVMI 161–200 g/m2; n=1,359); and Very-Severe-LVH (LVMI >200 g/m2; n=711). We then assessed mortality rate for a mean follow-up period of 5.8±4.5 years.
Results: Echocardiographic parameters are presented in table⇓. During the follow-up period we observed a total of 3,950 deaths for an annual mortality rate of 5.85% in the entire cohort. The annual mortality rate was 4.87%; 6.53%; 8%; and 11% for the No-LVH; Mild-Moderate-LVH; Severe-LVH; and Very-Severe-LVH groups respectively. Cox proportional hazard analysis, adjusted for age, heart failure, and diabetes mellitus, revealed a 10% increase in mortality risk for every 20 g/m2 increase in LVMI. When compared to the No-LVH group, the mortality risk was 29% higher for the Mild-Moderate-LVH (CI: 1.2–1.4); 57% higher for the Severe-LVH (CI: 1.4–1.7) and 115% higher for the Very-Severe-LVH (CI: 1.9–2.4).
LVMI is directly associated with increased mortality;
Severe and very severe LVH are associated with exaggerated mortality risk and
Approaches to prevent or reverse LVH are urgently needed.