TY - JOUR
T1 - Association of a 4-Tiered Classification of LV Hypertrophy with Adverse CV Outcomes in the General Population
AU - Garg, Sonia
AU - de Lemos, James A
AU - Ayers, Colby
AU - Khouri, Michel G.
AU - Pandey, Ambarish
AU - Berry, Jarett D
AU - Peshock, Ronald M
AU - Drazner, Mark H
N1 - Funding Information:
The Dallas Heart Study was funded by the Donald W. Reynolds Foundation and was partially supported by the National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR001105]. Dr. Drazner has received support from the James M. Wooten Chair in Cardiology, University of Texas Southwestern Medical Center. Drs. de Lemos, Berry, and Drazner are funded by the American Heart Association Strategically Focused Research Grant [14SFRN20740000]. Dr. de Lemos has received grant support from Roche Diagnostics and Abbott Diagnostics. All other authors have reported that they have no relationships relevant to the content of this paper to disclose.
Publisher Copyright:
© 2015 American College of Cardiology Foundation.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Objectives This study was performed to determine whether a 4-tiered classification of left ventricular hypertrophy (LVH) defines subgroups in the general population that are at variable risks of adverse cardiovascular (CV) outcomes. Background We recently proposed a 4-tiered classification of LVH where eccentric LVH is subdivided into "indeterminate hypertrophy" and "dilated hypertrophy" and concentric LVH into "thick hypertrophy" and "both thick and dilated hypertrophy," based on the presence of increased left ventricular (LV) end-diastolic volume. Methods Participants from the Dallas Heart study who underwent cardiac magnetic resonance and did not have LV dysfunction or a history of heart failure (HF) (n = 2,458) were followed for a median of 9 years for the primary outcome of HF or CV death. Multivariable Cox proportional hazards models were used to adjust for age, sex, African-American race, hypertension, diabetes, and history of CV disease. Results In the cohort, 70% had no LVH, 404 (16%) had indeterminate hypertrophy, 30 (1%) had dilated hypertrophy, 289 (12%) had thick hypertrophy, and 7 (0.2%) had both thick and dilated hypertrophy. The cumulative incidence of HF or CV death was 2% with no LVH, 1.7% with indeterminate, 16.7% with dilated, 11.1% with thick, and 42.9% with both thick and dilated hypertrophy (log-rank p < 0.0001). Compared with participants without LVH, those with dilated (hazard ratio [HR]: 7.3; 95% confidence interval [CI]: 2.8 to 18.8), thick (HR: 2.4; 95% CI: 1.4 to 4.0), and both thick and dilated (HR: 5.8; 95% CI: 1.7 to 19.5) hypertrophy remained at increased risk for HF or CV death after multivariable adjustment, whereas the group with indeterminate hypertrophy was not (HR: 0.9; 95% CI: 0.4 to 2.2). Conclusions In the general population, the 4-tiered classification system for LVH stratified LVH into subgroups with differential risk of adverse CV outcomes.
AB - Objectives This study was performed to determine whether a 4-tiered classification of left ventricular hypertrophy (LVH) defines subgroups in the general population that are at variable risks of adverse cardiovascular (CV) outcomes. Background We recently proposed a 4-tiered classification of LVH where eccentric LVH is subdivided into "indeterminate hypertrophy" and "dilated hypertrophy" and concentric LVH into "thick hypertrophy" and "both thick and dilated hypertrophy," based on the presence of increased left ventricular (LV) end-diastolic volume. Methods Participants from the Dallas Heart study who underwent cardiac magnetic resonance and did not have LV dysfunction or a history of heart failure (HF) (n = 2,458) were followed for a median of 9 years for the primary outcome of HF or CV death. Multivariable Cox proportional hazards models were used to adjust for age, sex, African-American race, hypertension, diabetes, and history of CV disease. Results In the cohort, 70% had no LVH, 404 (16%) had indeterminate hypertrophy, 30 (1%) had dilated hypertrophy, 289 (12%) had thick hypertrophy, and 7 (0.2%) had both thick and dilated hypertrophy. The cumulative incidence of HF or CV death was 2% with no LVH, 1.7% with indeterminate, 16.7% with dilated, 11.1% with thick, and 42.9% with both thick and dilated hypertrophy (log-rank p < 0.0001). Compared with participants without LVH, those with dilated (hazard ratio [HR]: 7.3; 95% confidence interval [CI]: 2.8 to 18.8), thick (HR: 2.4; 95% CI: 1.4 to 4.0), and both thick and dilated (HR: 5.8; 95% CI: 1.7 to 19.5) hypertrophy remained at increased risk for HF or CV death after multivariable adjustment, whereas the group with indeterminate hypertrophy was not (HR: 0.9; 95% CI: 0.4 to 2.2). Conclusions In the general population, the 4-tiered classification system for LVH stratified LVH into subgroups with differential risk of adverse CV outcomes.
KW - cardiac magnetic resonance
KW - heart failure
KW - hypertrophy
KW - left ventricular geometry
KW - troponin
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U2 - 10.1016/j.jcmg.2015.06.007
DO - 10.1016/j.jcmg.2015.06.007
M3 - Article
C2 - 26298074
AN - SCOPUS:84942587691
SN - 1936-878X
VL - 8
SP - 1034
EP - 1041
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 9
ER -