Impact of left ventricular geometry on prognosis in hypertensive patients with left ventricular hypertrophy (the LIFE

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Eva Gerdts1, Dana Cramariuc, Giovanni de Simone

  • 1Institute of Medicine, University of Bergen, N-5021 Bergen, Norway.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|May 21, 2008
PubMed

Insights

Changes in left ventricular (LV) geometry during treatment predict cardiovascular events in hypertensive patients with LV hypertrophy. Echocardiography reveals these evolving LV patterns add crucial risk information beyond baseline assessments.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Left ventricular (LV) hypertrophy is common in hypertensive patients.
  • The prognostic value of in-treatment changes in LV geometry is not well understood.
  • Assessing LV geometry over time may refine cardiovascular risk prediction.

Purpose of the Study:

  • To evaluate LV geometric patterns as time-varying predictors of cardiovascular events.
  • To analyze the impact of antihypertensive treatment on LV geometry.
  • To determine if echocardiographic LV geometry provides incremental risk information in hypertensive patients with LV hypertrophy.

Main Methods:

  • Analysis of 937 hypertensive patients from the LIFE echocardiography substudy.
  • Assessment of LV geometry (mass/body surface area and relative wall thickness) at baseline and annually.
  • Time-varying Cox regression models adjusted for clinical and treatment variables.

Main Results:

  • Significant improvements in LV geometry were observed, with 52% achieving normal geometry by study end.
  • Concentric remodeling and concentric LV hypertrophy showed substantial reductions.
  • In-treatment LV geometric patterns independently predicted increased risk of cardiovascular death, stroke, or myocardial infarction.

Conclusions:

  • In-treatment LV geometry assessed by echocardiography provides significant prognostic information in hypertensive patients with baseline LV hypertrophy.
  • Evolving LV geometry during treatment is a critical determinant of cardiovascular event risk.
  • These findings support the use of serial echocardiography for risk stratification in this population.
Abstract

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