Abstract 3901: Impact of Relative Wall Thickness on Left Ventricular Geometry and Mortality in 47,865 Patients With Preserved Systolic Function: Does the Method Matter?
Echocardiographic LV relative wall thickness (RWT) is typically determined using 2X posterior wall thickness (PWT)/LVEDd (LV end diastolic diameter); other methods include septal wall thickness (2 × SWT/LVEDd) or combination of both (PWT + SWT/LVEDd). However, data showing the comparison between RWT methods is scant. We evaluated 47,865 patients (mean age: 61.6±15.4 years; 54% female) to compare three methods of RWT and to examine their impact on LV geometry and mortality during an average follow-up of 1.7±1.0 years. Identification of LV geometry using different methods of RWT showed significant differences in prevalence of LV geometry (figure⇓). Prevalence of mortality in CR (increased RWT but no LVH) defined by RWT using PWT was significantly higher than SWT method but lower than PWT plus SWT method. Mortality prevalence in other LV geometric patterns was not different by RWT methods (figure⇓). RWT determined by PWT was the strongest predictor of mortality (table⇓) compared to other methods, in which RWT also were independent predictors of mortality. In conclusion, although all methods of RWT provide reasonable clinical accuracy for assessing LV geometry and prognosis, our results indicate that the PWT measurement is preferred, unless PWT is not easily measurable or severe septal asymmetry is present (as underestimation of RWT may occur if only PWT is used).