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Inappropriate left ventricular mass changes during treatment adversely affects cardiovascular prognosis in

Maria Lorenza Muiesan1, Massimo Salvetti, Anna Paini

  • 1Department of Medical and Surgical Sciences, University of Brescia, 25100 Brescia, Italy. muiesan@med.unibs.it

Hypertension (Dallas, Tex. : 1979)
|March 21, 2007
PubMed

Insights

Inappropriate left ventricular mass (LVM) during hypertension treatment increases cardiovascular event risk. Regression of inappropriate LVM improves prognosis, highlighting its importance in managing heart health.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Inappropriate left ventricular mass (LVM) is a predictor of cardiovascular (CV) events, irrespective of traditional hypertrophy definitions.
  • Understanding LVM changes during treatment is crucial for assessing CV risk.

Purpose of the Study:

  • To evaluate the relationship between changes in LVM appropriateness during antihypertensive treatment and subsequent CV prognosis.
  • To identify factors independently associated with CV events in hypertensive patients.

Main Methods:

  • Prospective study of 436 uncomplicated hypertensive subjects with baseline and follow-up echocardiograms (6+/-3 years apart).
  • LVM appropriateness assessed by the ratio of observed LVM to predicted LVM for individual cardiac workload.
  • Patients followed for an additional 4.5+/-2.5 years for CV events.

Main Results:

  • Inappropriate LVM at baseline was present in 258 patients.
  • Event rates varied significantly based on LVM appropriateness changes: persistence of inappropriate LVM (3.18 events/100 patient-years), regression (0.97), development (1.87), and persistence of appropriate LVM (0.81).
  • Persistence or development of inappropriate LVM, along with LVH, were independent predictors of CV events (P<0.001).

Conclusions:

  • The appropriateness of LVM relative to cardiac workload is a significant prognostic factor in hypertensive patients.
  • Changes in LVM appropriateness during antihypertensive therapy impact long-term CV outcomes.
  • Monitoring and managing inappropriate LVM is essential for improving CV prognosis in hypertension.

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