CLINICAL STUDIES
Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death
Agha W. Haider, MD, PhD*  ¶,
Martin G. Larson, ScD* ,
Emelia J. Benjamin, MD, ScM, FACC and
Daniel Levy, MD, FACC*  ||
* National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, USA
National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
The Section of Epidemiology and Preventive Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
Division of Cardiology, Boston Medical Center, Boston, Massachusetts, USA
¶ Massachusetts Veterans Epidemiology Research and Information Center, Harvard Medical School, Boston, Massachusetts, USA
|| Divisions of Cardiology and Clinical Epidemiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
Manuscript received February 10, 1998;
revised manuscript received May 20, 1998,
accepted June 22, 1998.
Address for correspondence: Dr. Daniel Levy, Framingham Heart Study, 5 Thurber Street, Framingham, Massachusetts 01702
dan{at}fram.nhlbi.nih.gov
Objectives. This study examined the relations of echocardiographically determined left ventricular (LV) mass and hypertrophy to the risk of sudden death.
Background. Echocardiographic LV hypertrophy is associated with increased risk for all-cause mortality and cardiovascular disease morbidity and mortality. However, little is known about the association of echocardiographic LV hypertrophy with sudden death.
Methods. We examined the relations of LV mass and hypertrophy to the incidence of sudden death in 3,661 subjects enrolled in the Framingham Heart Study who were  40 years of age. The baseline examination was performed from 1979 to 1983 and LV hypertrophy was defined as LV mass (adjusted for height) >143 g/m in men and >102 g/m in women. During up to 14 years of follow-up there were 60 sudden deaths. Cox models examined the relations of LV mass and LV hypertrophy to sudden death risk after adjusting for known risk factors.
Results. The prevalence of LV hypertrophy was 21.5%. The risk factor–adjusted hazard ratio (HR) for sudden death was 1.45 (95% confidence interval [CI] 1.10 to 1.92, p = 0.008) for each 50-g/m increment in LV mass. For LV hypertrophy, the risk factor–adjusted HR for sudden death was 2.16 (95% CI 1.22 to 3.81, p = 0.008). After excluding the first 4 years of follow-up, both increased LV mass and LV hypertrophy conferred long-term risk of sudden death (HR 1.53, 95% CI 1.01 to 2.28, p = 0.047 and HR 3.28, 95% CI 1.58 to 6.83, p = 0.002, respectively).
Conclusions. Increased LV mass and hypertrophy are associated with increased risk for sudden death after accounting for known risk factors.
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Abbreviations and Acronyms
| | CI | = confidence interval | | HR | = hazard ratio | | LV | = left ventricular |
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