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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Left ventricular geometry and all-cause mortality in advanced age
Ruth O Teh1, Ngaire M Kerse1, Elizabeth M Robinson2
1Department of General Practice and Primary Health Care, University of Auckland.
Insights
In older adults, abnormal heart structures like left ventricular hypertrophy (LVH) are common. Concentric remodelling and eccentric hypertrophy patterns are linked to increased mortality and adverse cardiovascular disease outcomes.
Area of Science:
- Cardiology
- Geriatric Medicine
- Echocardiography
Background:
- Cardiac structure and function abnormalities are prevalent in diverse populations, including those with and without cardiovascular disease (CVD).
- This study focuses on the elderly population, examining left ventricular hypertrophy (LVH) and its associated geometric patterns.
Purpose of the Study:
- To determine the prevalence of left ventricular hypertrophy (LVH) and its four geometric patterns in an elderly cohort.
- To establish the clinical characteristics and five-year outcomes for each LV geometry group.
Main Methods:
- Echocardiograms were performed on 100 participants from general practices and Māori Health Services in New Zealand.
- One cardiologist analyzed echocardiograms, blinded to participant clinical history.
Main Results:
- Thirty-two participants (32%) exhibited echocardiographic LVH.
- Concentric remodelling (CR) and eccentric hypertrophy (EH) were independently associated with higher risks of all-cause mortality and hospital admissions compared to normal geometry (NG).
- Eccentric hypertrophy (EH) also showed a higher risk of cardiovascular disease (CVD) events.
Conclusions:
- Despite high rates of CVD and hypertension, half of the elderly participants had normal left ventricular geometry.
- Concentric remodelling (CR) and eccentric hypertrophy (EH) are significant predictors of adverse outcomes, including mortality, in older adults.
Background:
Abnormalities of cardiac structure and function are common in a wide range of populations including those with and without established clinical cardiovascular disease (CVD). This study reports the prevalence of left ventricular hypertrophy (LVH), the four patterns of LV geometry and establishes clinical characteristics and five-year outcomes of each group in people of advanced age.
Method:
A study conducted in general practices and Māori Health Services in three New Zealand North Island locations. One hundred participants had a full clinical echocardiogram performed and analysed in 2008 by one experienced cardiologist blinded to the participant's clinical history.
Results:
Two-thirds of the participants had CVD. Thirty-two participants had echocardiographic LVH. Those with LVH had higher left atrial area [median (IQR) 26.4cm(2) (10.9) vs. 22.0cm(2) (7.0), p<0.01] and E/e' [median (IQR) 13 (6.8) vs.10.8 (4.1), p=0.01] than those without LVH. Of those with LVH, 10 demonstrated concentric hypertrophy (CH) and 22 eccentric hypertrophy (EH); 12 concentric remodelling (CR) and 40 normal geometry (NG). Both CR and EH were independently associated with higher risk of all-cause mortality (p<0.01) and hospital admissions (p<0.05) than those with NG. Those with EH also had a higher risk of CVD events (p=0.029).
Conclusions:
Despite a high prevalence of CVD and hypertension in this sample, half had normal LV geometry. Concentric remodelling and eccentric hypertrophy were associated with higher mortality and adverse CVD outcomes in people of advanced age.
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