| Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) Echocardiographic Study. | |
| | |
MedLine Citation:
|
PMID: 19356485 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: This study sought to understand prognostic implications of increased baseline left ventricular (LV) mass and geometric patterns in a high risk acute myocardial infarction. BACKGROUND: The LV hypertrophy and alterations in LV geometry are associated with an increased risk of adverse cardiovascular events. METHODS: Quantitative echocardiographic analyses were performed at baseline in 603 patients from the VALIANT (VALsartan In Acute myocardial iNfarcTion) echocardiographic study. The left ventricular mass index (LVMi) and relative wall thickness (RWT) were calculated. Patients were classified into 4 mutually exclusive groups based on RWT and LVMi as follows: normal geometry (normal LVMi and normal RWT), concentric remodeling (normal LVMi and increased RWT), eccentric hypertrophy (increased LVMi and normal RWT), and concentric hypertrophy (increased LVMi and increased RWT). Cox proportional hazards models were used to evaluate the relationships among LVMi, RWT, LV geometry, and clinical outcomes. RESULTS: Mean LVMi and RWT were 98.8 +/- 28.4 g/m(2) and 0.38 +/- 0.08. The risk of death or the composite end point of death from cardiovascular causes, reinfarction, heart failure, stroke, or resuscitation after cardiac arrest was lowest for patients with normal geometry, and increased with concentric remodeling (hazard ratio [HR]: 3.0; 95% confidence interval [CI]: 1.9 to 4.9), eccentric hypertrophy (HR: 3.1; 95% CI: 1.9 to 4.8), and concentric hypertrophy (HR: 5.4; 95% CI: 3.4 to 8.5), after adjusting for baseline covariates. Also, baseline LVMi and RWT were associated with increased mortality and nonfatal cardiovascular outcomes (HR: 1.22 per 10 g/m(2) increase in LVMi; 95% CI: 1.20 to 1.30; p < 0.001) (HR: 1.60 per 0.1-U increase in RWT; 95% CI: 1.30 to 1.90; p < 0.001). Increased risk associated with RWT was independent of LVMi. CONCLUSIONS: Increased baseline LV mass and abnormal LV geometry portend an increased risk for morbidity and mortality following high-risk myocardial infarction. Concentric LV hypertrophy carries the greatest risk of adverse cardiovascular events including death. Higher RWT was associated with an increased risk of cardiovascular complications after high-risk myocardial infarction. |
| | |
Authors:
|
Anil Verma; Alessandra Meris; Hicham Skali; Jalal K Ghali; J Malcolm O Arnold; Mikhail Bourgoun; Eric J Velazquez; John J V McMurray; Lars Kober; Marc A Pfeffer; Robert M Califf; Scott D Solomon |
Related Documents
:
|
9129885 - Coronary heart disease attack rate, incidence and mortality 1975-1994 in göteborg, swe... 1590225 - Effectiveness and safety of a single intravenous bolus injection of tissue-type plasmin... 16773275 - Low density lipoprotein cholesterol, statins and cardiovascular events: a meta-analysis. 18093295 - Detection of non-st-elevation myocardial infarction and unstable angina in the acute se... 16227145 - A statin in the treatment of heart failure? controlled rosuvastatin multinational study... 9415275 - Pharmacodynamics of basic fibroblast growth factor: route of administration determines ... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: JACC. Cardiovascular imaging Volume: 1 ISSN: 1876-7591 ISO Abbreviation: JACC Cardiovasc Imaging Publication Date: 2008 Sep |
Date Detail:
|
Created Date: 2009-04-09 Completed Date: 2009-04-23 Revised Date: 2009-05-21 |
Medline Journal Info:
|
Nlm Unique ID: 101467978 Medline TA: JACC Cardiovasc Imaging Country: United States |
Other Details:
|
Languages: eng Pagination: 582-91 Citation Subset: IM |
Affiliation:
|
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angiotensin II Type 1 Receptor Blockers / therapeutic use* Cardiovascular Diseases / etiology*, mortality, prevention & control, ultrasonography Europe Female Heart Ventricles / physiopathology, ultrasonography* Humans Hypertrophy, Left Ventricular / etiology, mortality, ultrasonography* Kaplan-Meiers Estimate Male Middle Aged Myocardial Infarction / complications*, drug therapy, mortality, ultrasonography Predictive Value of Tests Proportional Hazards Models Recurrence Risk Assessment Risk Factors Tetrazoles / therapeutic use* Time Factors Treatment Outcome United States Valine / analogs & derivatives*, therapeutic use Ventricular Remodeling* |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin II Type 1 Receptor Blockers; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine |
| Comments/Corrections | |
Comment In:
|
JACC Cardiovasc Imaging. 2008 Sep;1(5):592-4
[PMID:
19356486
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Relationship of magnetic resonance imaging estimation of myocardial iron to left ventricular systoli...
Next Document: Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain ...