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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Incremental prognostic value of a complex left ventricular remodeling classification in asymptomatic for heart

Iacopo Fabiani1, Nicola Riccardo Pugliese1, Salvatore La Carrubba2

  • 1Dipartimento di Patologia Medica, Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy.

Journal of the American Society of Hypertension : JASH
|June 17, 2017
PubMed

Insights

A new complex remodeling classification (CRC) accurately predicts poor outcomes in asymptomatic patients with arterial hypertension (AH). This advanced assessment tool identifies high-risk individuals, enabling proactive cardiovascular management.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Hypertension Research

Background:

  • Arterial hypertension (AH) poses significant cardiovascular risks.
  • Assessing cardiac remodeling is crucial for prognostication in hypertensive patients.
  • Current classifications may not fully capture prognostic information in asymptomatic individuals.

Purpose of the Study:

  • To evaluate the prognostic impact of a novel complex remodeling classification (CRC) in asymptomatic patients with arterial hypertension (AH).
  • To determine if CRC is an independent predictor of adverse cardiovascular events in this population.

Main Methods:

  • Retrospective analysis of 749 asymptomatic hypertensive patients (Stages A/B heart failure).
  • CRC assessment included indexed left ventricular mass, end-diastolic volume, and relative wall thickness.
  • A composite endpoint (mortality, MI, revascularization, stroke, pulmonary edema) was tracked over 45 months.

Main Results:

  • Kaplan-Meier analysis revealed significantly different survival across CRC-derived classes (P < .001).
  • Cox regression identified CRC as an independent predictor of poor outcome (P = .01) after adjusting for multiple confounders.
  • 73 events (9.7%) were observed during follow-up.

Conclusions:

  • The complex remodeling classification (CRC) is a valuable independent predictor of adverse outcomes in asymptomatic patients with arterial hypertension.
  • CRC offers enhanced prognostic stratification beyond traditional risk factors and classic remodeling assessments.
  • This classification may guide more precise cardiovascular risk management strategies in hypertensive individuals.

Keywords:
Echocardiographyejection fractionhypertensionremodeling

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