CLINICAL RESEARCH: LEFT VENTRICULAR MASS IN CARDIAC DISEASE
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
Mark H. Drazner, MD, MSc, FACC*,*,
J. Eduardo Rame, MD, MPhil*,
Emily K. Marino, MS¶,
John S. Gottdiener, MD, FACC ,
Dalane W. Kitzman, MD, FACC ,
Julius M. Gardin, MD, FACC ,
Teri A. Manolio, MD, PhD||,
Daniel L. Dries, MD, MPH* and
David S. Siscovick, MD, MPH#
* Heart Failure Research Unit, Donald W. Reynolds Cardiovascular Clinical Research Center, Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Division of Cardiology, St. Francis Hospital, Roslyn, New York, USA
Cardiology Section, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
Division of Cardiology, St. John Hospital and Medical Center and Wayne State University, Detroit, Michigan, USA
|| Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
¶ Department of Biostatistics, University of Washington, Seattle, Washington, USA
# Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, Washington, USA
Manuscript received July 15, 2003;
revised manuscript received November 17, 2003,
accepted November 24, 2003.
* Reprint requests and correspondence: Dr. Mark H. Drazner, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9047, USA.
mark.drazner{at}utsouthwestern.edu
OBJECTIVES: 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).
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: Increased LVM as assessed by electrocardiography or echocardiography is an independent risk factor for the development of depressed LVEF.
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Abbreviations and Acronyms
| | BSA | = body surface area | | CHS | = Cardiovascular Health Study | | CI | = confidence interval | | FS | = fractional shortening | | LV | = left ventricular | | LVEF | = left ventricular ejection fraction | | LVM | = left ventricular mass |
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|
|
|
|
|
|
|
N. Rodondi, D. C. Bauer, A. R. Cappola, J. Cornuz, J. Robbins, L. P. Fried, P. W. Ladenson, E. Vittinghoff, J. S. Gottdiener, and A. B. Newman
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|
|
|
|
|
|
|
A. Baltabaeva, M. Marciniak, B. Bijnens, J. Moggridge, F. J. He, T. F. Antonios, G. A. MacGregor, and G. R. Sutherland
Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension
Eur J Echocardiogr,
July 1, 2008;
9(4):
501 - 508.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Phrommintikul, L. Tran, A. Kompa, B. Wang, A. Adrahtas, D. Cantwell, D. J. Kelly, and H. Krum
Effects of a Rho kinase inhibitor on pressure overload induced cardiac hypertrophy and associated diastolic dysfunction
Am J Physiol Heart Circ Physiol,
April 1, 2008;
294(4):
H1804 - H1814.
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[Full Text]
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|
|
|
|
|
|
|
J. A. Hill and E. N. Olson
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N. Engl. J. Med.,
March 27, 2008;
358(13):
1370 - 1380.
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[PDF]
|
|
|
|
|
|
|
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Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study
Eur. Heart J.,
March 2, 2008;
29(6):
741 - 747.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Frank, C. Kuhn, M. van Eickels, D. Gehring, C. Hanselmann, S. Lippl, R. Will, H. A. Katus, and N. Frey
Calsarcin-1 Protects Against Angiotensin-II Induced Cardiac Hypertrophy
Circulation,
November 27, 2007;
116(22):
2587 - 2596.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
W. J. Paulus, C. Tschope, J. E. Sanderson, C. Rusconi, F. A. Flachskampf, F. E. Rademakers, P. Marino, O. A. Smiseth, G. De Keulenaer, A. F. Leite-Moreira, et al.
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Eur. Heart J.,
October 2, 2007;
28(20):
2539 - 2550.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
P. M. Okin, R. B. Devereux, K. E. Harris, S. Jern, S. E. Kjeldsen, S. Julius, J. M. Edelman, B. Dahlof, and for the LIFE Study Investigators
Regression of Electrocardiographic Left Ventricular Hypertrophy Is Associated with Less Hospitalization for Heart Failure in Hypertensive Patients
Ann Intern Med,
September 4, 2007;
147(5):
311 - 319.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Rosendorff, H. R. Black, C. P. Cannon, B. J. Gersh, J. Gore, J. L. Izzo Jr, N. M. Kaplan, C. M. O'Connor, P. T. O'Gara, and S. Oparil
REPRINT Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention
Hypertension,
August 1, 2007;
50(2):
e28 - e55.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Rosendorff, H. R. Black, C. P. Cannon, B. J. Gersh, J. Gore, J. L. Izzo Jr, N. M. Kaplan, C. M. O'Connor, P. T. O'Gara, and S. Oparil
Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention
Circulation,
May 29, 2007;
115(21):
2761 - 2788.
[Full Text]
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|
|
|
|
|
|
|
G. C. Kane, A. Behfar, R. B. Dyer, D. F. O'Cochlain, X.-K. Liu, D. M. Hodgson, S. Reyes, T. Miki, S. Seino, and A. Terzic
KCNJ11 gene knockout of the Kir6.2 KATP channel causes maladaptive remodeling and heart failure in hypertension
Hum. Mol. Genet.,
August 1, 2006;
15(15):
2285 - 2297.
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[Full Text]
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|
|
|
|
|
|
|
D. S. Lee, M. J. Pencina, E. J. Benjamin, T. J. Wang, D. Levy, C. J. O'Donnell, B.-H. Nam, M. G. Larson, R. B. D'Agostino, and R. S. Vasan
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N. Engl. J. Med.,
July 13, 2006;
355(2):
138 - 147.
[Abstract]
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|
|
|
|
|
|
|
S. Klotz, I. Hay, G. Zhang, M. Maurer, J. Wang, and D. Burkhoff
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May 1, 2006;
47(5):
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|
|
|
|
|
|
|
A. G. Bertoni, D. C. Goff Jr, R. B. D'Agostino Jr, K. Liu, W. G. Hundley, J. A. Lima, J. F. Polak, M. F. Saad, M. Szklo, R. P. Tracy, et al.
Diabetic Cardiomyopathy and Subclinical Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA).
Diabetes Care,
March 1, 2006;
29(3):
588 - 594.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. N. Bairey Merz, L. J. Shaw, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, C. J. Pepine, S. Mankad, B. L. Sharaf, et al.
Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part II: Gender Differences in Presentation, Diagnosis, and Outcome With Regard to Gender-Based Pathophysiology of Atherosclerosis and Macrovascular and Microvascular Coronary Disease
J. Am. Coll. Cardiol.,
February 7, 2006;
47(3_Suppl_S):
S21 - S29.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. M. Okin, R. B. Devereux, M. S. Nieminen, S. Jern, L. Oikarinen, M. Viitasalo, L. Toivonen, S. E. Kjeldsen, B. Dahlof, and for the LIFE Study Investigators
Electrocardiographic Strain Pattern and Prediction of New-Onset Congestive Heart Failure in Hypertensive Patients: The Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study
Circulation,
January 3, 2006;
113(1):
67 - 73.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. H. Drazner
The Transition From Hypertrophy to Failure: How Certain Are We?
Circulation,
August 16, 2005;
112(7):
936 - 938.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Rosen, T. Edvardsen, S. Lai, E. Castillo, L. Pan, M. Jerosch-Herold, S. Sinha, R. Kronmal, D. Arnett, J. R. Crouse III, et al.
Left Ventricular Concentric Remodeling Is Associated With Decreased Global and Regional Systolic Function: The Multi-Ethnic Study of Atherosclerosis
Circulation,
August 16, 2005;
112(7):
984 - 991.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Berenji, M. H. Drazner, B. A. Rothermel, and J. A. Hill
Does load-induced ventricular hypertrophy progress to systolic heart failure?
Am J Physiol Heart Circ Physiol,
July 1, 2005;
289(1):
H8 - H16.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. H. Drazner, D. L. Dries, R. M. Peshock, R. S. Cooper, C. Klassen, F. Kazi, D. Willett, and R. G. Victor
Left Ventricular Hypertrophy Is More Prevalent in Blacks Than Whites in the General Population: The Dallas Heart Study
Hypertension,
July 1, 2005;
46(1):
124 - 129.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. G. Fuster, J. A. M. Argudo, O. G. Albarova, F. H. Sos, S. C. Lopez, M. B. Codoner, J. A. B. Minano, and I. R. Albarran
Patient-prosthesis mismatch in aortic valve replacement: really tolerable?
Eur. J. Cardiothorac. Surg.,
March 1, 2005;
27(3):
441 - 449.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Gardin and M. S. Lauer
Left Ventricular Hypertrophy: The Next Treatable, Silent Killer?
JAMA,
November 17, 2004;
292(19):
2396 - 2398.
[Full Text]
[PDF]
|
|
|
|
|
|
|
LV Hypertrophy Portends LV Dysfunction
Journal Watch (General),
July 30, 2004;
2004(730):
1 - 1.
[Full Text]
|
|
|
|
|
|
|
B. D. Rosen, T. Edvardsen, S. Lai, E. Castillo, L. Pan, M. Jerosch-Herold, S. Sinha, R. Kronmal, D. Arnett, J. R. Crouse III, et al.
Left Ventricular Concentric Remodeling Is Associated With Decreased Global and Regional Systolic Function: The Multi-Ethnic Study of Atherosclerosis
Circulation,
August 16, 2005;
112(7):
984 - 991.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
