Left Ventricular Remodeling Patterns in Primary Healthcare.

Area of Science:

• Cardiology
• Nephrology
• Echocardiography

Background:

• Left ventricular remodeling (LVR) is a significant predictor of adverse non-fatal and fatal cardiovascular outcomes.
• Understanding the geometric patterns of LVR is crucial for risk stratification and management.

Purpose of the Study:

• To characterize the geometric patterns of left ventricular remodeling (LVR) in a Brazilian population.
• To investigate the associations between LVR patterns and clinical/laboratory variables.

Main Methods:

• A cross-sectional study involving 636 individuals aged 45-99 years in Rio de Janeiro, Brazil.
• Evaluations included clinical assessment, laboratory tests, electrocardiogram, and tissue Doppler echocardiography (TDE).
• Statistical analyses used Kruskal-Wallis, Pearson's Chi-square, and logistic regression to assess associations with LVR patterns (normal geometry, concentric remodeling, concentric hypertrophy, eccentric hypertrophy).

Main Results:

• The prevalence of altered left ventricular geometry was 33%.
• Eccentric hypertrophy (EH) was the most common altered pattern (29%), followed by concentric hypertrophy (2%) and concentric remodeling (2%).
• Gender, age, education level, and albumin/creatinine ratio (A/C) were independently associated with the likelihood of EH.

Conclusions:

• Approximately one-third of the study cohort exhibited left ventricular remodeling, placing them at risk for heart failure.
• An altered urinary albumin/creatinine ratio was linked to eccentric hypertrophy, suggesting an early interplay between cardiac and renal dysfunction.