Small Left Ventricular Chamber Size and Mortality in a Large General Population

Area of Science:

• Cardiology
• Echocardiography
• Public Health

Background:

• Left ventricular (LV) enlargement signifies adverse cardiac remodeling and poor prognosis.
• Previous research indicated cardiovascular risk in small patient subsets with small LV chamber size.
• The prognostic impact of small LV chamber size in the general population remained largely unexamined.

Purpose of the Study:

• To investigate the association between small left ventricular (LV) chamber size and all-cause mortality in a large, general population cohort.
• To determine if small LV chamber size is an independent predictor of mortality across diverse demographic groups.

Main Methods:

• Retrospective analysis of 46,529 subjects undergoing echocardiography between 2011 and 2023.
• Small LV chamber size defined by American Society of Echocardiography guidelines (end-diastolic diameter <42 mm for men, <37.8 mm for women).
• Multivariable analysis assessed the association between small LV size and all-cause mortality, adjusting for clinical and echocardiographic variables.

Main Results:

• A small LV chamber size was identified in 3,787 subjects and was associated with older age and lower body surface area.
• Higher relative wall thickness and E/e' ratio were observed in subjects with small LV chambers.
• Small LV chamber size significantly predicted all-cause mortality (HR 1.34, 95% CI 1.22-1.46, p <0.001) in multivariable analysis, irrespective of age or sex.

Conclusions:

• Small left ventricular (LV) chamber size is a significant, independent predictor of all-cause mortality in a broad patient population.
• The association between small LV size and mortality was consistent across younger and older individuals, as well as men and women.
• Further research is warranted to understand the underlying mechanisms and develop targeted preventive strategies for individuals with small LV chambers.