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Subclassification of left ventricular hypertrophy based on dilation stratifies coronary artery disease patients with

Bao-Tao Huang1, Yong Peng, Wei Liu

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

European Journal of Clinical Investigation
|August 9, 2014
PubMed

Insights

Dilated left ventricular hypertrophy (LVH) in coronary artery disease (CAD) patients indicates worse outcomes. Eccentric dilated LVH showed the highest risk for death and composite events, while eccentric nondilated LVH did not predict adverse events.

Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Outcomes

Background:

  • A novel 4-tiered classification for left ventricular hypertrophy (LVH) categorizes geometry by concentricity and dilation.
  • The prognostic implications of this LVH classification in patients with coronary artery disease (CAD) remain unclear.

Purpose of the Study:

  • To investigate the association between LV geometry patterns and clinical outcomes in patients with CAD.
  • To determine if the new LVH classification provides distinct prognostic information.

Main Methods:

  • Echocardiographic assessment of left ventricular mass (LVM) and end-diastolic volume (EDV) in 2297 CAD patients.
  • Classification of LV geometry into five groups: eccentric nondilated LVH, eccentric dilated LVH, concentric nondilated LVH, concentric dilated LVH, and normal LV mass.
  • Analysis of all-cause death and composite events using Cox regression.

Main Results:

  • Dilated LVH (both eccentric and concentric) was associated with significantly higher rates of all-cause death and composite events compared to nondilated LVH.
  • Eccentric dilated LVH demonstrated the highest risk for all-cause death (aHR 2.752) and composite events (aHR 2.462).
  • Eccentric nondilated LVH showed comparable risks for adverse outcomes to normal LV mass.

Conclusions:

  • LVH geometry, specifically dilation, provides significant and distinct prognostic information in patients with CAD.
  • Eccentric nondilated LVH is not associated with adverse outcomes.
  • The classification aids in risk stratification for CAD patients with LVH.
Abstract

Keywords:
Coronary artery diseaseechocardiographyleft ventricular geometryleft ventricular remoulding

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