Supranormal Left Ventricular Ejection Fraction, Concentric Remodeling, and Long-Term Survival.

Area of Science:

• Cardiology
• Echocardiography
• Clinical Research

Background:

• Supranormal left ventricular ejection fraction (LVEF) is paradoxically linked to increased mortality.
• The role of intrinsic left ventricular (LV) structural changes in this phenomenon remains unclear.

Purpose of the Study:

• To investigate the prognostic significance of supranormal LVEF.
• To examine the interaction between supranormal LVEF and LV concentric remodeling.

Main Methods:

• Analysis of echocardiography data from 67,108 participants with LVEF >60%.
• LV concentric remodeling defined as relative wall thickness >0.42.
• Cox models and restricted cubic splines used to assess all-cause mortality risk.
• Subgroup analyses stratified by LV concentric remodeling.

Main Results:

• LVEF >70% was associated with significantly higher all-cause mortality risk (adjusted HR: 1.15; 95% CI: 1.05-1.26).
• A significant interaction between LVEF and LV concentric remodeling was found (P <0.001).
• Higher mortality risk with supranormal LVEF was predominantly observed in individuals with LV concentric remodeling, particularly women.

Conclusions:

• Supranormal LVEF (>70%) is an independent risk factor for all-cause mortality.
• LV concentric remodeling amplifies the mortality risk associated with supranormal LVEF.
• Women with LV concentric remodeling and supranormal LVEF face the highest mortality risk.