Longitudinal Decrease in Left Ventricular Size with Age: Impact on Mortality and Cardiovascular Hospitalization

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Remodeling

Background:

• Small left ventricular (LV) chamber size can indicate adverse cardiac remodeling and impact prognosis.
• The prognostic implications of LV size reduction in individuals with normal baseline LV size are not well understood.

Purpose of the Study:

• To investigate the clinical characteristics and outcomes associated with longitudinal decreases in LV size.
• To clarify the prognostic significance of declining LV size in hearts with normal baseline dimensions.

Main Methods:

• Analysis of echocardiographic data from 6,232 adults with normal baseline LV end-diastolic diameter (LVEDD).
• Participants were categorized based on LVEDD change (no change, decreased ≥5 mm, increased ≥5 mm) over a mean 4.8-year interval.

Main Results:

• A 5 mm or greater decrease in LVEDD occurred in 24% of participants and was independently associated with increased mortality (HR 1.19).
• Annual LVEDD decrease (>1 mm/year) significantly predicted mortality and death/cardiovascular hospitalization.
• Both increasing and decreasing LV end-diastolic volumes correlated with adverse outcomes.

Conclusions:

• Progressive decrease in LVEDD within normal-sized hearts is an independent predictor of adverse outcomes.
• Declining left ventricular size holds significant prognostic importance in cardiovascular health.