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Subclassification of Left Ventricular Hypertrophy Based on Dilation Stratifies Coronary Artery Disease Patients with Distinct Risk.
MedLine Citation:
PMID:  25104141     Owner:  NLM     Status:  Publisher    
BACKGROUND: A new 4-classification of left ventricular hypertrophy (LVH) based on LV concentricity and dilation has been proposed, however, the association between the new categorization of LV geometry and outcomes in patients with coronary artery disease (CAD) is still unknown.
METHODS: All the 2297 CAD patients included underwent echocardiographic examination prior to discharge. Left ventricular mass (LVM) was calculated and left ventricular end-diastolic volume (EDV) was indexed by body surface area (BSA). Study cohort were divided into 5 groups according to LV geometry: 1) eccentric non-dilated LVH (normal LVM/EDV((2/3)) and EDV/BSA) (n=129); 2) eccentric dilated LVH (normal LVM/EDV((2/3)) with increased EDV/BSA) (n=222); 3) concentric non-dilated LVH (increased LVM/EDV((2/3)) with normal EDV/BSA) (n=441); 4) concentric dilated LVH (increased LVM/EDV((2/3)) and EDV/BSA) (n=118); 5) normal LV mass (n=1387).
RESULTS: Dilated LVH was associated with a higher event rates of all-cause death (eccentric 13.1% vs. 3.1%; concentric: 13.6% vs. 8.4%) and composite events (eccentric: 17.6% vs. 5.4%; concentric: 18.6% vs. 12.7%) compared with non-dilated LVH. While eccentric non-dilated LVH had comparable risk for adverse outcomes compared with normal LV mass (all-cause death: relative risk (RR) 0.68, 95% confidential interval (CI) 0.25-1.85; composite events: RR 0.75, 95% CI 0.36-1.58). Cox regression analyses showed that eccentric dilated LVH had the highest propensity to all-cause death (adjusted hazard ratio [aHR] 2.752 [95% CI 1.749-4.328], P<0.001) and composite events (aHR 2.462 [95% CI 1.688-3.592], P<0.001).
CONCLUSION: In patients with CAD, dilated and non-dilated LVH provide distinct prognostic information. Eccentric non-dilated LVH does not predict adverse outcomes. This article is protected by copyright. All rights reserved.
Bao-Tao Huang; Yong Peng; Wei Liu; Chen Zhang; Fang-Yang Huang; Peng-Ju Wang; Zhi-Liang Zuo; Yan-Biao Liao; Hua Chai; Qiao Li; Zhen-Gang Zhao; Xiao-Lin Luo; Xin Ren; Kai-Sen Huang; Qing-Tao Meng; Chi Chen; De-Jia Huang; Mao Chen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-7
Journal Detail:
Title:  European journal of clinical investigation     Volume:  -     ISSN:  1365-2362     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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