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Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:06 America/Los_Angeles — eenright
| Title | Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2004 |
| Authors | Drazner, MH, J Rame, E, Marino, EK, Gottdiener, JS, Kitzman, DW, Gardin, JM, Manolio, TA, Dries, DL, Siscovick, DS |
| Journal | J Am Coll Cardiol |
| Volume | 43 |
| Issue | 12 |
| Pagination | 2207-15 |
| Date Published | 2004 Jun 16 |
| ISSN | 0735-1097 |
| Keywords | Aged, Body Surface Area, Coronary Artery Disease, Diastole, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Ventricles, Humans, Hypertrophy, Left Ventricular, Longitudinal Studies, Male, Multivariate Analysis, Prospective Studies, Risk Factors, Sensitivity and Specificity, Statistics as Topic, Stroke Volume, Ventricular Dysfunction, Left |
| Abstract | <p><b>OBJECTIVES: </b>Our aim in this study was to determine whether increased left ventricular mass (LVM) is a risk factor for the development of a reduced left ventricular ejection fraction (LVEF).</p><p><b>BACKGROUND: </b>Prior studies have shown that increased LVM is a risk factor for heart failure but not whether it is a risk factor for a low LVEF.</p><p><b>METHODS: </b>As part of the Cardiovascular Health Study, a prospective population-based longitudinal study, we performed echocardiograms upon participant enrollment and again at follow-up of 4.9 +/- 0.14 years. In the present analysis, we identified 3,042 participants who had at baseline a normal LVEF and an assessment of LVM (either by electrocardiogram or echocardiogram), and at follow-up a measurable LVEF. The frequency of the development of a qualitatively depressed LVEF on two-dimensional echocardiography, corresponding approximately to an LVEF <55%, was analyzed by quartiles of baseline LVM. Multivariable regression determined whether LVM was independently associated with the development of depressed LVEF.</p><p><b>RESULTS: </b>Baseline quartile of echocardiographic LVM indexed to body surface area was associated with development of a depressed LVEF (4.8% in quartile 1, 4.4% in quartile 2, 7.5% in quartile 3, and 14.1% in quartile 4 [p < 0.001]). A similar relationship was seen in the subgroup of participants without myocardial infarction (p < 0.001). In multivariable regression that adjusted for confounders, both baseline echocardiographic (p < 0.001) and electrocardiographic (p < 0.001) LVM remained associated with development of depressed LVEF.</p><p><b>CONCLUSIONS: </b>Increased LVM as assessed by electrocardiography or echocardiography is an independent risk factor for the development of depressed LVEF.</p> |
| DOI | 10.1016/j.jacc.2003.11.064 |
| Alternate Journal | J Am Coll Cardiol |
| PubMed ID | 15193681 |
| Grant List | N01-HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States |