Abstract 4035: Left Ventricular Geometry and Mortality Prediction by Different Indexation Methods for Left Ventricular Mass by Obesity Status in 47,865 Patients
Echocardiographically determined LV mass (LVM) is often indexed to body surface area (BSA), but this may not accurately characterize the influence of obesity on LVM and related mortality. We evaluated 18,630 obese (BMI ≥30; age: 59±14 yr) as well as 29,235 non-obese (BMI <30; age: 63±17 yr) with preserved EF to determine the impact of LVM indexed to either BSA or Ht2.7 on prevalence of abnormal LV geometry as per standard methods [concentric remodeling (CR), and eccentric (EH) or concentric (CH) LV hypertrophy (LVH)] and mortality during a mean follow-up of 1.7±1.0 yrs. Compared to non-obese, obese had higher LVM index (LVM/BSA: 84±30 vs. 88±27 g/m2, p<0.0001; LVM/Ht2.7: 37±13 vs. 45±15 g/m2.7, p<0.0001). Both indices were significantly correlated, albeit less so in obese than non-obese (r=0.92 vs. 0.97). LVM indexed to either BSA or Ht2.7 independently predicted mortality in both obese and non-obese groups (all p<0.0001). The LVM/BSA method produced a higher prevalence of normal and CR but lower prevalence of EH and CH compared with the LVM/Ht2.7 method (figure⇓), especially in moderate (BMI kg/m2 35– 40) and severe (BMI>40 kg/m2) obesity. However, the LVM/BSA method had higher mortality in CR, EH and CH compared with the LVM/Ht2.7 method, especially in obesity. In conclusion:
Subtle differences in the classification of LV geometry exist between the two LVM indexing methods was noted, particularly in patients with more marked degrees of obesity.
LV geometric classifications using LVM corrected by either BSA or Ht2.7 predict mortality, both in obese and non-obese patients.