Indexing left ventricular wall thickness to body surface area improves prognostic value

Area of Science:

• Cardiology
• Medical Imaging
• Prognostics

Background:

• Current guidelines for normal left ventricular (LV) wall thickness (WT) do not utilize indexing to body surface area (BSA).
• The prognostic value of indexed WT for mortality risk remains underexplored in clinical practice.

Purpose of the Study:

• To investigate the hypothesis that indexing LV wall thickness (WT) to body surface area (BSA) enhances its prognostic capability.
• To compare the predictive accuracy of indexed WT against non-indexed WT and LV mass index (LVMI) for mortality risk.

Main Methods:

• A retrospective analysis of 9737 patients who underwent echocardiography was performed.
• The relationship between LV wall thickness (WT) and body surface area (BSA) was examined.
• The association of WT, LV mass index (LVMI), and indexed WT with mortality was assessed, adjusting for age and gender.

Main Results:

• A significant linear relationship was observed between body surface area (BSA) and left ventricular (LV) wall thickness (WT).
• Indexed mean WT (MWT) demonstrated the highest prognostic value for mortality prediction (C-statistic 0.67) compared to non-indexed MWT and LVMI.
• Patients with indexed MWT in the 8th decile or higher showed significantly increased adjusted mortality risk.

Conclusions:

• Indexing left ventricular wall thickness (WT) to body surface area (BSA) provides improved mortality prediction over non-indexed WT and LVMI.
• The findings support the routine use of indexed WT for enhanced risk stratification in echocardiographic assessments.