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Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death
A W Haider1, M G Larson, E J Benjamin
1National Heart, Lung, and Blood Institute's Framingham Heart Study, Massachusetts 01702, USA.
Insights
Increased left ventricular (LV) mass and LV hypertrophy significantly elevate the risk of sudden cardiac death. This finding highlights the importance of monitoring LV structure for cardiovascular risk assessment.
Area of Science:
- Cardiology
- Echocardiography
- Sudden Cardiac Death Risk Stratification
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for mortality and cardiovascular events.
- The specific association between echocardiographically determined LVH and sudden death remains less understood.
Purpose of the Study:
- To investigate the relationship between left ventricular (LV) mass and LV hypertrophy, as measured by echocardiography, and the risk of sudden cardiac death.
- To determine if LV structure predicts sudden death independently of other cardiovascular risk factors.
Main Methods:
- Analysis of 3,661 Framingham Heart Study participants (age >= 40) with baseline echocardiograms (1979-1983).
- LV hypertrophy defined by LV mass indexed to height (>143 g/m for men, >102 g/m for women).
- Cox proportional hazards models used to assess sudden death risk over 14 years, adjusting for covariates.
Main Results:
- Prevalence of LV hypertrophy was 21.5%.
- Each 50-g/m increment in LV mass increased sudden death risk (HR 1.45).
- LV hypertrophy was associated with a 2.16-fold increased risk of sudden death (HR 2.16).
- Both increased LV mass and LV hypertrophy predicted long-term sudden death risk after initial follow-up years.
Conclusions:
- Elevated left ventricular mass and hypertrophy are significant, independent predictors of sudden cardiac death.
- Echocardiographic assessment of LV structure is crucial for identifying individuals at heightened risk for sudden death.
Objectives:
This study examined the relations of echocardiographically determined left ventricular (LV) mass and hypertrophy to the risk of sudden death.
Background:
Echocardiographic LV hypertrophy is associated with increased risk for all-cause mortality and cardiovascular disease morbidity and mortality. However, little is known about the association of echocardiographic LV hypertrophy with sudden death.
Methods:
We examined the relations of LV mass and hypertrophy to the incidence of sudden death in 3,661 subjects enrolled in the Framingham Heart Study who were > or =40 years of age. The baseline examination was performed from 1979 to 1983 and LV hypertrophy was defined as LV mass (adjusted for height) > 143 g/m in men and > 102 g/m in women. During up to 14 years of follow-up there were 60 sudden deaths. Cox models examined the relations of LV mass and LV hypertrophy to sudden death risk after adjusting for known risk factors.
Results:
The prevalence of LV hypertrophy was 21.5%. The risk factor-adjusted hazard ratio (HR) for sudden death was 1.45 (95% confidence interval [CI] 1.10 to 1.92, p=0.008) for each 50-g/m increment in LV mass. For LV hypertrophy, the risk factor-adjusted HR for sudden death was 2.16 (95% CI 1.22 to 3.81, p=0.008). After excluding the first 4 years of follow-up, both increased LV mass and LV hypertrophy conferred long-term risk of sudden death (HR 1.53, 95% CI 1.01 to 2.28, p=0.047 and HR 3.28, 95% CI 1.58 to 6.83, p=0.002, respectively).
Conclusions:
Increased LV mass and hypertrophy are associated with increased risk for sudden death after accounting for known risk factors.