Document Detail


Usefulness of stress echocardiography for risk stratification and prognosis of patients with left ventricular hypertrophy.
MedLine Citation:
PMID:  17659943     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to evaluate the role of stress echocardiography in the risk stratification and prognosis of patients with left ventricular (LV) hypertrophy. One thousand two patients (mean age 62 +/- 13 years, 35% men) with LV hypertrophy (defined by LV mass index >115 g/m(2) for men and >95 g/m(2) for women) were evaluated. LV mass was calculated using the linear dimension method, as recommended by the American Society of Echocardiography. The calculation of relative wall thickness was performed using the formula (2 x posterior wall thickness)/LV internal diameter. Concentric and eccentric LV hypertrophy were defined as relative wall thicknesses > or =0.42 and <0.42 cm, respectively. Follow-up (2.6 +/- 1.1 years) for confirmed myocardial infarction and cardiac death (n = 71) was obtained. Four hundred seventy-three patients (47%) had concentric hypertrophy, and 529 patients (53%) had eccentric hypertrophy. In patients with either concentric or eccentric LV hypertrophy, stress echocardiography was able to effectively risk-stratify normal versus abnormal subgroups (event rate 1.1% vs 4.9% per year, p <0.0001), whereas stress electrocardiography was unable to do so. In the cohort with normal stress echocardiographic results, patients with concentric LV hypertrophy had an event rate 5 times higher than those with eccentric LV hypertrophy (event rate 1.7% vs 0.3% per year, p = 0.007). In conclusion, stress echocardiography effectively risk-stratifies patients with LV hypertrophy compared with stress electrocardiography. Normal stress echocardiographic results in patients with concentric LV hypertrophy indicate a worse prognosis than in patients with eccentric LV hypertrophy, probably reflecting decreased sensitivity in this cohort. However, abnormal stress echocardiographic results portend a worse prognosis in patients with either concentric or eccentric LV hypertrophy.
Authors:
Sripal Bangalore; Siu-Sun Yao; Farooq A Chaudhry
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Publication Detail:
Type:  Journal Article     Date:  2007-06-19
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-30     Completed Date:  2007-10-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  536-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Cardiology, St. Luke's-Roosevelt Hospital and Columbia University, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Echocardiography, Stress*
Female
Heart Diseases / mortality
Humans
Hypertrophy, Left Ventricular / complications,  ultrasonography*
Male
Middle Aged
Myocardial Infarction / etiology
Prognosis
Risk Assessment

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


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