Document Detail

Left ventricular dilatation and the risk of congestive heart failure in people without myocardial infarction.
MedLine Citation:
PMID:  9134875     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular dilatation is a well-recognized precursor of ventricular dysfunction and congestive heart failure after myocardial infarction. The effect of left ventricular dilatation on the risk of heart failure in people initially free of myocardial infarction is not known. METHODS: We examined the relation of the left ventricular end-diastolic and end-systolic internal dimensions, as measured by M-mode echocardiography, to the risk of congestive heart failure in 4744 subjects (2083 men and 2661 women) who had not sustained a myocardial infarction and who were free of congestive heart failure. We used sex-stratified proportional-hazards regression to assess the association between base-line left ventricular internal dimensions and the subsequent risk of congestive heart failure, after adjusting for age, blood pressure, hypertension treatment, body-mass index, diabetes, valve disease, and interim myocardial infarction. RESULTS: Over an 11-year follow-up period, congestive heart failure developed in 74 subjects (38 men and 36 women). The risk-factor-adjusted hazard ratio for congestive heart failure was 1.47 (95 percent confidence interval, 1.25 to 1.73) for an increment of 1 SD in the left ventricular end-diastolic dimension, indexed for height. We obtained similar results using the left ventricular end-systolic dimension (hazard ratio, 1.43; 95 percent confidence interval, 1.24 to 1.65). CONCLUSIONS: An increase in left ventricular internal dimension is a risk factor for congestive heart failure in men and women who have not had a myocardial infarction. Knowledge of the left ventricular dimension improves predictions of the risk of congestive heart failure made on the basis of traditional risk factors, perhaps by aiding in the identification of subjects with subclinical left ventricular dysfunction.
R S Vasan; M G Larson; E J Benjamin; J C Evans; D Levy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  336     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-05-08     Completed Date:  1997-05-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1350-5     Citation Subset:  AIM; IM    
Framingham Heart Study, MA 01701, USA.
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MeSH Terms
Follow-Up Studies
Heart Failure / etiology*
Heart Ventricles / pathology,  ultrasonography
Hypertrophy, Left Ventricular / complications*,  pathology,  ultrasonography
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Risk Factors
Grant Support
Comment In:
N Engl J Med. 1997 May 8;336(19):1381-2   [PMID:  9134880 ]

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