Related Experiment Video
Updated: Aug 7, 2026
06:34
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
U-Shaped Association Between Left Ventricular Dimension and Mortality in Patients With Heart Failure
Hua Wang1, Liwei Zhang1, Chen Ji1
1Department of Cardiology, Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
JAMA Cardiology
|August 5, 2026
Summary
Both small and large left ventricles (LV) are linked to increased mortality risk in heart failure (HF) patients. This U-shaped association highlights the importance of LV size in predicting outcomes and guiding personalized HF management.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Left ventricular (LV) structural assessment is crucial for heart failure (HF) management.
- The independent prognostic value of LV size, beyond ejection fraction, is not well-defined in large populations.
Purpose of the Study:
- To investigate the association between LV dimensions and mortality risk in a large, nationwide HF cohort.
- To determine if LV size independently predicts mortality in heart failure patients.
Main Methods:
- Nationwide cohort study using the Chinese Cardiovascular Association Database-Heart Failure Center Registry (2018-2022).
- Included 273,921 hospitalized HF patients categorized by LV end-diastolic diameter (LVEDD) using American Society of Echocardiography criteria.
- Analyzed all-cause and cardiovascular mortality, adjusting for relevant covariates.
Main Results:
- A significant U-shaped association was observed between LVEDD and both all-cause and cardiovascular mortality (P < .001).
- Both small (aHR, 1.32) and large (aHR, 1.38) LVs were independently associated with elevated all-cause mortality.
- Sex-specific optimal LVEDD thresholds were identified, with deviations increasing mortality risk.
Conclusions:
- A U-shaped association exists between LVEDD and mortality in HF patients.
- Both abnormally small and large LV dimensions are independent predictors of increased mortality risk.
- LV size assessment should be integrated into routine risk stratification for personalized HF management.
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