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CLINICAL STUDY: RISK FACTORS

Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study

^a ANMCO Research Center, Via La Marmora, 36 Firenze, Italy. Please see for MAVI Study Group participants

Manuscript received December 30, 2000; revised manuscript received August 14, 2001, accepted August 29, 2001.

^* Reprint requests and correspondence: Dr. Paolo Verdecchia, ANMCO Research Center, Via La Marmora, 39, 50121-Firenze, Italy
verdec{at}tin.it

OBJECTIVES

This study investigated the prognostic value of left ventricular (LV) mass at echocardiography in uncomplicated subjects with essential hypertension.

BACKGROUND

Only a few single-center studies support the prognostic value of LV mass in uncomplicated hypertension.

METHODS

The MAssa Ventricolare sinistra nell’Ipertensione study was a multicenter (45 centers) prospective study. The prespecified aim was to explore the prognostic value of LV mass in hypertension. Admission criteria included essential hypertension, no previous cardiovascular events, and age 50. There was central reading of echocardiographic tracings. Treatment was tailored to the single subject.

RESULTS

Overall, 1,033 subjects (396 men) were followed for 0 to 4 years (median, 3 years). Mean age at entry was 60 years, and systolic/diastolic blood pressure was 154/92 mm Hg. The rate of cardiovascular events (x100 patient-years) was 1.3 in the group with normal LV mass and 3.2 in the group (28.5% of total sample) with LV mass 125 g/body surface area (p = 0.005). After adjustment for age (p < 0.01), diabetes (p < 0.01), cigarette smoking (p < 0.01) and serum creatinine (p = 0.03), LV hypertrophy was associated with an increased risk of events (RR [relative risk] 2.08; 95% CI [confidence interval]: 1.22 to 3.57). For each 39 g/m² (1 SD) increase in LV mass there was an independent 40% rise in the risk of major cardiovascular events (95% CI: 14 to 72; p = 0.0013).

CONCLUSIONS

Our findings show a strong, continuous and independent relationship of LV mass to subsequent cardiovascular morbidity. This is the first study to extend such demonstration to a large nationwide multicenter sample of uncomplicated subjects with essential hypertension.

Abbreviations and Acronyms   ANMCO = Associazione Nazionale Medici Cardiologi Ospedalieri   BP = blood pressure   BSA = body surface area   ECG = electrocardiography   LV = left ventricular   MAVI = Massa Ventricolare Sinistra nell’Ipertensione   MI = myocardial infarction

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