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
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Figure 1 Number of participants meeting inclusion criteria.
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Figure 2 Percentage of participants developing a depressed left ventricular ejection fraction by baseline quartile of left ventricular mass (LVM) (A) and LVM indexed to body surface area (BSA) (B) or height (C). Baseline LVM was assessed by echocardiography or electrocardiography (ECG). P < 0.001 for the association of LVM irrespective of indexation method with incident depressed ejection fraction in all cases. White bars = quartile 1; bars with horizontal lines = quartile 2; bars with diagonal lines = quartile 3; black bars = quartile 4. Quartiles of echocardiographic LVM (g):  114.7, 114.8 to 137.2, 137.4 to 165.7, >165.7, respectively. Quartiles of electrocardiographic LVM (g): <128.1, 128.1 to 145.4, 145.43 to 167.2, and >167.2, respectively. Quartiles of echocardiographic LVM/BSA (g/m2): 67.7, 67.8 to 79.2, 79.3 to 93.5, and >93.5, respectively. Quartiles of electrocardiographic LVM/BSA (g/m2): <76.9, 76.9 to 83, 83.1 to 90.3, and >90.3, respectively. Quartiles of echocardiographic LVM/height (g/m): 70.40, 70.42 to 84.13, 84.14 to 99.97, and >99.97, respectively. Quartiles of electrocardiographic LVM/height (g/m): 79.48, 79.49 to 88.51, 88.52 to 99.49, and >99.49, respectively.
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Figure 3 Subgroup analysis: percentage of participants developing a depressed left ventricular ejection fraction by baseline quartile of echocardiographic left ventricular mass (LVM) indexed to body surface area (BSA). "No coronary artery disease" subgroup consisted of participants without prevalent or interval myocardial infarction, coronary artery bypass grafting, or percutaneous transluminal angioplasty. "No diabetes" and "no heart failure" excluded participants with these conditions present at baseline, and "no atrial fibrillation" excluded those with atrial fibrillation at baseline or during follow-up. P < 0.001 for the association of LVM/BSA and incident depressed ejection fraction for all groups shown. White bars = quartile 1; bars with horizontal lines = quartile 2; bars with diagonal lines = quartile 3; black bars = quartile 4. Quartile values of echocardiographic LVM/BSA are as reported in Figure 2.
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