Abstract 898: Left Ventricular Hypertrophy Patterns and the Incidence of Heart Failure: The Framingham Heart Study
Background Higher LV mass, wall thickness and internal dimension are associated with increased HF incidence, but it is unclear if different LV hypertrophy patterns confer varying risk.
Methods We related LV hypertrophy patterns to HF incidence in 4765 Framingham Study participants (mean age 50 years; 56% women). LV hypertrophy patterns were defined based on sex-specific distributions of echocardiographic LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT<80th percentile), concentric remodeling (LVM<but RWT≥80th percentile), eccentric hypertrophy (LVM≥but RWT <80th percentile), and concentric hypertrophy (LVM and RWT≥80th percentile).
Results On follow-up (mean 20 years), 396 participants (8.3%; 218 women) developed HF. The age- and sex-adjusted 20-year HF event-rate/100-persons rose from 6.54 in normal LV group to 9.08, 13.11 and 14.77 in the concentric remodeling, concentric hypertrophy and eccentric hypertrophy groups, respectively. In multivariable Cox models, LV hypertrophy pattern was associated with HF incidence relative to normal LV (p= 0.004): risk was greatest in those with eccentric hypertrophy (hazards ratio [HR] 1.72, 95% confidence interval [CI] 1.28 –2.32). Concentric hypertrophy and remodeling were not associated with HF risk (HR 1.29, 95% CI 0.95–1.74, and 1.09, 95% CI 0.81–1.47, respectively). We had limited power to exclude modest associations (HR of 1.30 or less) of the latter patterns with HF risk.
Conclusions In our large community-based sample, HF risk varied with LV hypertrophy patterns, with eccentric hypertrophy carrying the greatest HF risk relative to other patterns.