Document Detail

Natural history of concentric left ventricular geometry in community-dwelling older adults without heart failure during seven years of follow-up.
MedLine Citation:
PMID:  21129719     Owner:  NLM     Status:  MEDLINE    
Presence of concentric left ventricular (LV) geometry has important pathophysiologic and prognostic implications. However, little is known about its natural history in older adults. Of the 5,795 community-dwelling adults ≥65 years of age in the Cardiovascular Health Study, 1,871 without baseline heart failure had data on baseline and 7-year echocardiograms. Of these 343 (18%) had baseline concentric LV geometry (concentric remodeling 83%, concentric LV hypertrophy [LVH] 17%) and are the focus of the present study. LV geometry at year 7 was categorized into 4 groups based on LVH (LV mass indexed for height >51 g/m²·⁷) and relative wall thickness (RWT): eccentric hypertrophy (RWT ≤0.42 with LVH), concentric hypertrophy (RWT >0.42 with LVH), concentric remodeling (RWT >0.42 without LVH), and normal (RWT ≤0.42 without LVH). At year 7, LV geometry normalized in 57%, remained unchanged in 35%, and transitioned to eccentric hypertrophy in 7% of participants. Incident eccentric hypertrophy occurred in 4% and 25% of those with baseline concentric remodeling and concentric hypertrophy, respectively, and was associated with increased LV end-diastolic volume and decreased LV ejection fraction at year 7. Previous myocardial infarction and baseline above-median LV mass (>39 g/m²·⁷) and RWT (>0.46) had significant unadjusted associations with incident eccentric LVH; however, only LV mass >39 g/m²·⁷ (odds ratio 17.52, 95% confidence interval 3.91 to 78.47, p <0.001) and previous myocardial infarction (odds ratio 4.73, 95% confidence interval 1.16 to 19.32, p = 0.031) had significant independent associations. In conclusion, in community-dwelling older adults with concentric LV geometry, transition to eccentric hypertrophy was uncommon but structurally maladaptive.
Ravi V Desai; Mustafa I Ahmed; Marjan Mujib; Inmaculada B Aban; Michael R Zile; Ali Ahmed
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-12-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  107     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-07     Completed Date:  2011-04-05     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  321-4     Citation Subset:  AIM; IM    
Copyright Information:
Published by Elsevier Inc.
University of Alabama at Birmingham, USA.
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MeSH Terms
Disease Progression
Follow-Up Studies
Heart Failure
Heart Ventricles / physiopathology,  ultrasonography*
Hypertrophy, Left Ventricular / physiopathology,  ultrasonography*
Prospective Studies
Stroke Volume
Time Factors
Ventricular Remodeling / physiology*
Grant Support
R01 HL085561-03/HL/NHLBI NIH HHS; R01 HL097047-01/HL/NHLBI NIH HHS; R01-HL085561/HL/NHLBI NIH HHS; R01-HL097047/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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