Abstract 17907: Is the Association of Left Ventricular Geometry with Cardiovascular Outcomes Independent of Left Ventricular Mass?
Background: Left ventricle (LV) geometry is an important predictor of adverse cardiovascular (CV) outcomes. Although an abnormal LV shape is often associated with changes in LV mass, it is not completely explained by the latter. Further, it is unclear if adverse effects of abnormal LV geometry are independent of LV mass. The objective of this study was to test the hypothesis that abnormal LV geometry would predict adverse outcomes independent of LV mass.
Methods: Of the 5795 community-dwelling adults ≥65 years in the Cardiovascular Health Study, 3210 were free of baseline heart failure (HF) and had baseline echocardiographic data. Relative wall thickness (RWT) was computed by the ratio of sum of interventricular septal and posterior wall thickness to LV end-diastolic dimension. Since RWT showed a significant quadratic trend (p-value for square of RWT <0.001) with both outcomes (incident HF and all-cause mortality) suggesting a U shaped relationship, we categorized it into RWT tertiles: (1) <0.32, n=1062 (2) 0.32–0.38, n=1077 and (3) ≥0.38, n=1071. We used tertile 2 as the reference category in the step-wise Cox regression model relating tertiles 1 and 3 with outcomes.
Results: Participants had a mean age of 73 (±5) yrs, 60% women and 5% African American. Centrally-adjudicated incident HF occurred in 19%, 17% and 22% of participants with RWT tertiles 1, 2 and 3 respectively during over 10 years of follow-up. Respective rates for death were 40%, 36% and 48%. Hazard ratio (95% confidence intervals) for incident HF and death associated with RWT tertiles 1 and 3 (reference, tertile 2) are displayed in Table.
Conclusions: LV geometry, while closely related to LV mass, has an independent association with cardiovascular morbidity and mortality.
- © 2010 by American Heart Association, Inc.