Abstract 1690: Progression of Echocardiographic Left Ventricular Mass and Cardiovascular Disease Events in Elderly Adults: The Cardiovascular Health Study
Objective Our aim in this study was to examine whether change in left ventricular (LV) mass is associated with subsequent cardiovascular disease (CVD) events.
Background Previous studies have identified baseline LV mass as a strong and independent risk factor for adverse CVD outcomes, including future coronary heart disease (CHD), heart failure (HF) and stroke. However, the prognostic significance of progression of LV mass is not established.
Methods We studied 2366 persons initially aged 65 to 98 (36% female) within the Cardiovascular Health Study, a prospective epidemiologic study, who had baseline and follow-up echocardiograms (echos) performed 4.9 ± 0.14 years apart. LV mass was calculated from LV dimensions and wall thickness, derived from 2D directed M-mode echos. Participants were followed for an additional 12.7 ± 3.9 years for the occurrence of CVD events. Multivariable Cox regression examined association of LV mass change, analyzed as a continuous variable, with future CVD events, including endpoints of CHD, HF and stroke. Analyses were adjusted for baseline LV mass as well as age, sex and other risk factors.
Results Over the follow-up, a total of 1009 CVD events occurred, including 649 CHD, 315 stroke and 481 incident HF events. LV mass change, adjusted for baseline LV mass, age, sex and risk factors, was associated with a modest increase in risk of CVD events, including HF and CHD, but not stroke (table⇓). LV mass increases of 1 and 2 standard deviations (≥13.4g and ≥26.9g respectively) above the mean change (+ 1.8 g) had hazard ratios (95% CIs) of 1.40 (1.15–1.69, p + 0.006) and 1.72 (1.28 –2.32, p = 0.0004) respectively for CVD events. Age, diabetes, hypertension, smoking and baseline LV mass were also associated with CVD events (p < 0.005).
Conclusions Increases in LV mass, adjusted for baseline LV mass, are associated with only a modest increase in risk for CVD events, suggesting minimal clinical utility of serial echos for evaluation of future CVD risk in this cohort.