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Prognostic Significance of Increased Left Ventricular Mass Index to Mortality and Sudden Death in Patients with Stable Coronary Heart Disease (From the Heart & Soul Study)
- Publication Year :
- 2008
-
Abstract
- Data are limited about the significance of left ventricular (LV) hypertrophy or mass in patients with coronary heart disease (CHD), particularly in the setting of normal ejection fraction (EF). The association of LV mass index with all-cause mortality and sudden death in a cohort with CHD was evaluated. Using transthoracic echocardiography, LV mass normalized to body surface area was measured in 1,016 subjects with stable CHD. Cox proportional hazards models were used to examine the association of LV mass index and LV hypertrophy (LV mass index95 g/m(2) in women and115 in men) with time to death and time to sudden or arrhythmic death. Mean LV mass index was 101 +/- 27 g/m(2) in men and 88 +/- 23 in women. During a mean follow-up of 3.55 years, there were 146 deaths and 34 sudden or arrhythmic deaths. Total mortality was higher in subjects with LV hypertrophy (25% vs 11%, p0.001), as was mortality from sudden or arrhythmic death (6.7% vs 2.2%, p = 0.001). After adjustment for age, gender, cardiovascular risk factors, and medical therapy, LV hypertrophy was associated with both all-cause mortality (hazard ratio 2.0, p0.001) and sudden or arrhythmic death (hazard ratio 3.1, p = 0.003). Findings were similar in the subgroup with EFor =55% (mortality hazard ratio 1.8, p = 0.02; sudden and arrhythmic death hazard ratio 3.1, p = 0.02). Analyzed as a continuous variable, every 20-unit increase in LV mass index increased the adjusted hazard of death by 22% (p = 0.001) and adjusted hazard of sudden or arrhythmic death by 40% (p = 0.004). In conclusion, in patients with stable CHD, increased LV mass index was independently associated with all-cause mortality and sudden or arrhythmic death, even in subjects with normal EF.
- Subjects :
- Male
medicine.medical_specialty
Coronary Disease
Sudden death
Article
Muscle hypertrophy
Internal medicine
Medicine
Humans
Mass index
Aged
Body surface area
Ejection fraction
business.industry
Proportional hazards model
Hazard ratio
Stroke Volume
Stroke volume
Organ Size
Middle Aged
Prognosis
Echocardiography, Doppler
Death, Sudden, Cardiac
Cardiology
Female
Hypertrophy, Left Ventricular
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....1bc722c2e7e848ec7d57ad13f9489fec