Abstract 12245: Which Echocardiographic Indexing Method for Left Ventricular Hypertrophy Best Predicts Mortality Risk in Women?
Background: Cardiovascular (CV) disease is the leading cause of mortality in women. Although left ventricular hypertrophy (LVH) is a predictor of subsequent CV morbidity and mortality, only limited data is available on LVH in women, including whether LVH is best determined by echocardiography as left ventricular mass (LVM) indexed to body size [either body surface area (BSA) or height 2.7 (Ht2.7)]. Patients and
Methods: We evaluated 26,128 female patients with preserved ejection fraction to determine the impact of LVM indexed to either BSA (LVH=LVM index >96 g/m2) or Ht2.7 (LVH=LVM index >51g/m2.7) on prevalence of LVH and subsequent mortality during an average follow-up of 1.7 ±1.0 years.
Results: During follow-up, 1,947 women died and had significantly higher LVM (157.3±60.6g vs. 146.7 ± 53.8g, p<0.0001) and prevalence of LVH [by LVM/BSA (25.9% vs. 13.8%, p<0.0001) or by LMV/ Ht2.7 (26.5% vs. 16.9%, p<0.0001)] than did the 24,181 survivors. Both LVM indices were significantly correlated (r=0.74, p<0.0001) and were concordant in determining the presence or absence of LVH in 93% of women. In the 7% (n=1,845) of women where categorical LVH was discordant between the two indexing methods, LVH determined by LVM indexed to BSA (15.4% vs. 6.4%, p <0.0001) predicted an increase in mortality compared to women without LVH, whereas LVH determined by LVM indexed to Ht2.7 did not (7.0 vs. 6.4, p=NS) (Figure).
Conclusions: Echocardiographically determined LVH strongly predicts mortality in women. Although both indexing methods predict mortality, classification of LVH using LVM indexed to BSA is superior to LVM indexed to Ht2.7 in predicting mortality in female patients.
- © 2011 by American Heart Association, Inc.