Association of a favorable cardiovascular health profile (Life"s Simple 7 and Fuster-BEWAT scores) with the presence of a newly proposed 4-tiered left ventricular hypertrophy

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
HY Wang ◽  
YX Sun
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Cardiovascular Health ◽  
Low Cost ◽  
Left Ventricular ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Funding Sources ◽  
End Diastolic Volume ◽  
C Statistic

Abstract Funding Acknowledgements Type of funding sources: None. Background AHA"s Life"s Simple 7 cardiovascular health score is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT score (FBS) (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]), are also available. Purpose This study sought to compare the effectiveness of Life"s Simple 7 and FBS in predicting the newly proposed 4-tiered left ventricular hypertrophy (LVH) classification based on LV dilatation (high LV end-diastolic volume [EDV] index) and concentricity (mass/end-diastolic volume [M/EDV]0.67) in the general Chinese population. Methods Participants from Northeast China Rural Cardiovascular Health study who underwent cardiac echocardiography (n = 11,261) were enrolled. Patients with LVH were divided into 4 groups—eccentric nondilated (normal M/EDV and EDV), eccentric dilated (increased EDV, normal M/EDV), concentric nondilated (increased M/EDV, normal EDV), and concentric dilated (increased M/EDV and EDV)—and compared with patients with normal LVM. Results With poor Life"s Simple 7 and FBS as references, individuals with ideal Life"s Simple 7 and FBS showed lower adjusted odds of having eccentric nondilated (Life"s Simple 7, odds ratio [OR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.34 vs. FBS, OR: 0.28; 95% CI: 0.20 to 0.38), eccentric dilated (OR: 0.73 [0.57-0.94] vs. OR: 0.57 [0.43-0.76]), concentric nondilated (OR: 0.12 [0.04-0.38] vs. OR: 0.19 [0.07-0.52]), and concentric dilated LVH (OR: 0.12 [0.03-0.37] vs. OR: 0.26 [0.10-0.72]). Taken together, the odds for these 4 LV geometric phenotypes decreased in a graded manner in subjects with intermediate and ideal ICHS and FBS compared with subjects with poor ICHS and FBS (p for trend <0.01). For the total ICHS and FBS on a continuous scale from 0 (all 7 poor) to 7 (all 7 ideal), risk reductions of the 4 distinct LVH patterns were of comparable magnitude for each 1-point increment of ICHS and FBS. Similar levels of significantly discriminating accuracy were found for Life"s Simple 7 and FBS with respect to the eccentric nondilated (C-statistic: 0.737; 95% CI: 0.725 to 0.750 vs. 0.731; 95% CI: 0.718 to 0.744, respectively), eccentric dilated (0.684 [0.670-0.699] vs. 0.686 [0.671-0.701]), concentric nondilated (0.658 [0.624-0.692] vs. 0.650 [0.615-0.684]), and concentric dilated LVH (0.711 [0.678-0.744] vs. 0.698 [0.663-0.733]). Conclusions  Our findings demonstrate that the FBS appears capable of performing just as well as does the Life"s Simple 7 in predicting the novel 4-group classification of LVH, making the FBS particularly suited as a reliable low-cost indicator of CV health in settings where access to laboratory analysis is limited and health care resources are constrained. Abstract Figure.

Abstract 381: Life’s Simple 7 Cardiovascular Health Metrics versus Fuster-BEWAT Score to Predict the New 4-tiered Left Ventricular Hypertrophy Classification: Insight From a Large Asian-population

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Haoyu Wang ◽  
Yingxian Sun ◽  
Zugui Zhang ◽  
Kefei Dou ◽  
Jiang He
Keyword(s):  
Cardiovascular Health ◽  
Low Cost ◽  
Asian Population ◽  
Left Ventricular ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
End Diastolic Volume ◽  
C Statistic ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Background: AHA's Life's Simple 7 cardiovascular health score is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT score (FBS) (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]), are also available. This study sought to compare the effectiveness of Life's Simple 7 and FBS in predicting the newly proposed 4-tiered LVH classification based on LV dilatation (high LV end-diastolic volume [EDV] index) and concentricity (mass/end-diastolic volume [M/EDV] 0.67 ) in the general Chinese population. Methods: Participants from Northeast China Rural Cardiovascular Health study who underwent cardiac echocardiography (n=11,261) were enrolled. Patients with LVH were divided into 4 groups—eccentric nondilated (normal M/EDV and EDV), eccentric dilated (increased EDV, normal M/EDV), concentric nondilated (increased M/EDV, normal EDV), and concentric dilated (increased M/EDV and EDV)—and compared with patients with normal LVM. Results: With poor Life's Simple 7 and FBS as references, individuals with ideal Life's Simple 7 and FBS showed lower adjusted odds of having eccentric nondilated (Life's Simple 7, odds ratio [OR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.34 vs. FBS, OR: 0.28; 95% CI: 0.20 to 0.38), eccentric dilated (OR: 0.73 [0.57-0.94] vs. OR: 0.57 [0.43-0.76]), concentric nondilated (OR: 0.12 [0.04-0.38] vs. OR: 0.19 [0.07-0.52]), and concentric dilated LVH (OR: 0.12 [0.03-0.37] vs. OR: 0.26 [0.10-0.72]). Similar levels of significantly discriminating accuracy were found for Life's Simple 7 and FBS with respect to the eccentric nondilated (C-statistic: 0.737; 95% CI: 0.725 to 0.750 vs. 0.731; 95% CI: 0.718 to 0.744, respectively), eccentric dilated (0.684 [0.670-0.699] vs. 0.686 [0.671-0.701]), concentric nondilated (0.658 [0.624-0.692] vs. 0.650 [0.615-0.684]), and concentric dilated LVH (0.711 [0.678-0.744] vs. 0.698 [0.663-0.733]). Conclusions: Our findings demonstrate that the FBS appears capable of performing just as well as does the Life's Simple 7 in predicting the novel 4-group classification of LVH, making the FBS particularly suited as a reliable low-cost indicator of CV health in settings where access to laboratory analysis is limited and health care resources are constrained.

Life's simple 7 cardiovascular health metrics versus Fuster-BEWAT score to predict the new 4-tiered left ventricular hypertrophy classification: insight from a large Asian population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H.Y Wang ◽  
Y.X Sun ◽  
K.F Dou ◽  
J He
Keyword(s):  
Cardiovascular Health ◽  
Asian Population ◽  
Left Ventricular ◽  
Laboratory Analysis ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Funding Source ◽  
End Diastolic Volume ◽  
Life’S Simple 7 ◽  
Life's Simple 7

Abstract Background AHA's Life's Simple 7 cardiovascular health score is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT score (FBS) (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]), are also available. This study sought to compare the effectiveness of Life's Simple 7 and FBS in predicting the newly proposed 4-tiered LVH classification based on LV dilatation (high LV end-diastolic volume [EDV] index) and concentricity (mass/end-diastolic volume [M/EDV]0.67) in the general Chinese population. Methods Participants from Northeast China Rural Cardiovascular Health study who underwent cardiac echocardiography (n=11,261) were enrolled. Patients with LVH were divided into 4 groups–eccentric nondilated (normal M/EDV and EDV), eccentric dilated (increased EDV, normal M/EDV), concentric nondilated (increased M/EDV, normal EDV), and concentric dilated (increased M/EDV and EDV)–and compared with patients with normal LVM. LVH was classified as increased LV mass when indexed to height2.7 using thresholds of≥48 g/m2.7 for men and ≥39 g/m2.7 for women. Previously defined thresholds for elevated EDV indexed to BSA (≥74 ml/m2 for men and ≥68 ml/m2 for women) and M/EDV0.67 (≥9.1 g/ml0.67 for men and ≥8.1 g/ml0.67 for women) were used. Results With poor Life's Simple 7 and FBS as references, individuals with ideal Life's Simple 7 and FBS showed lower adjusted odds of having eccentric nondilated (Life's Simple 7, odds ratio [OR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.34 vs. FBS, OR: 0.28; 95% CI: 0.20 to 0.38), eccentric dilated (OR: 0.73 [0.57–0.94] vs. OR: 0.57 [0.43–0.76]), concentric nondilated (OR: 0.12 [0.04–0.38] vs. OR: 0.19 [0.07–0.52]), and concentric dilated LVH (OR: 0.12 [0.03–0.37] vs. OR: 0.26 [0.10–0.72]). For the total ICHS and FBS on a continuous scale from 0 (all 7 poor) to 7 (all 7 ideal), risk reductions of the four distinct LVH patterns were of comparable magnitude for each 1-point increment of ICHS and FBS. Similar levels of significantly discriminating accuracy were found for Life's Simple 7 and FBS with respect to the eccentric nondilated (C-statistic: 0.737; 95% CI: 0.725 to 0.750 vs. 0.731; 95% CI: 0.718 to 0.744, respectively), eccentric dilated (0.684 [0.670–0.699] vs. 0.686 [0.671–0.701]), concentric nondilated (0.658 [0.624–0.692] vs. 0.650 [0.615–0.684]), and concentric dilated LVH (0.711 [0.678–0.744] vs. 0.698 [0.663–0.733]). Conclusions Our findings demonstrate that the FBS appears capable of performing just as well as does the Life's Simple 7 in predicting the novel 4-group classification of LVH, making the FBS particularly suited as a reliable low-cost indicator of CV health in settings where access to laboratory analysis is limited and health care resources are constrained. Therefore, it may be considered the first option in settings where access to laboratory analysis is limited. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China

Carotid artery measures are strongly associated with left ventricular mass in older adults (A report from the cardiovascular health study)

1996 ◽  
Vol 77 (8) ◽  
pp. 628-633 ◽  
Author(s):  
Richard A. Kronmal ◽  
Vivienne-Elizabeth Smith ◽  
Daniel H. O'Leary ◽  
Joseph F. Polak ◽  
Julius M. Gardin ◽  
...  
Keyword(s):  
Older Adults ◽  
Carotid Artery ◽  
Left Ventricular Mass ◽  
Cardiovascular Health ◽  
Left Ventricular ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Ventricular Mass

Abstract 2386: Asymptomatic Left Ventricular Systolic Dysfunction as a Predictor of Incident Heart Failure and Mortality in the Elderly: The Cardiovascular Health Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jay Pandhi ◽  
Willem J Kop ◽  
John S Gottdiener
Keyword(s):  
Heart Failure ◽  
Cardiac Death ◽  
Cardiovascular Health ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Increased Risk

Left ventricular systolic dysfunction (LVSD) is an important predictor of outcomes in heart failure (HF) patients. Adverse effects of LVSD in individuals without heart failure, also known as asymptomatic LVSD (ALVSD), are not well established in the elderly. This study reports outcomes and evaluates the impact of LVSD in elderly subjects with ALVSD. The Cardiovascular Health Study is a multicenter longitudinal cohort study designed to assess cardiac risk factors and outcomes in a community-based population 65 years and older. The incidence of HF and mortality was evaluated in those with ALVSD with a median follow-up of 11.9 years. Cox regression was used, adjusting for demographics and cardiac risk factors, and stratified by severity of LVSD. Incident HF occurred in 39.2% of those with ALVSD vs. 22.8% in those without LVSD (RR = 1.51, CI = 1.25–1.84). Impaired ejection fraction (EF) (< 45%) was associated with more than twice the risk of incident HF than normal systolic function (RR = 2.21; CI 1.67–2.91). Individuals with borderline EF (45–55%) did not have an increased risk of incident HF (RR = 1.21; CI 0.94–1.56). The severity of LVSD was also predictive of mortality: borderline LVSD RR = 1.23 (CI 1.04–1.47) for all-cause mortality and 1.60 (CI 1.26–2.03) for cardiac death; impaired LVSD RR = 1.54 (CI 1.24–1.92) for all-cause mortality and RR = 2.12 (CI 1.60–2.81) for cardiac death. ALVSD is associated with increased risk of heart failure, death, and cardiac death when compared to normal systolic function. Furthermore, the degree of systolic dysfunction has a significant impact in predicting these outcomes in elderly individuals with ALVSD.

Abstract P369: Left Ventricular Hypertrophy and Coronary Heart Disease Risk Reclassification in Blacks and Whites: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Tochi Okwuosa ◽  
Elsayed Z Soliman ◽  
Alvaro Alonso ◽  
Kim A Williams ◽  
Faye Lopez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Risk Model ◽  
Left Ventricular ◽  
C Statistic ◽  
Framingham Risk ◽  
Ecg Score

Introduction: Left ventricular hypertrophy (LVH) is more prevalent in blacks than whites, and is a major independent predictor of coronary heart disease (CHD)/CVD survival in blacks. We evaluated the ability of LVH to predict CHD outcomes beyond traditional cardiovascular risk factors in blacks, compared with whites from a large community-based cohort. Methods: Data were analyzed on 14,489 participants (mean age 54 +/- 5.7 years, 43.5% men, and 26% black) within the ARIC cohort, with baseline (1987-1989) electrocardiograms (ECG), followed through 2009. Risk estimates for incident CHD were assessed using the 10-year Framingham Risk Score (FRS). Model 1 was the Framingham base model, while model 2 included the base model plus LVH by any of 11 traditional ECG-LVH criteria (Table). Net reclassification improvement (NRI) was calculated, and the distribution of risk was compared using model 2 vs. model 1. Results: There were 690 (4.8%) 10-year and 1515 (10.5%) 20-year CHD events. LVH defined by any criteria was associated with CHD events in the entire cohort [HR (95% CI): 1.42 (1.20-1.7)]. LVH defined by the Framingham ECG score and LV strain criteria were the criteria most associated with CHD overall. LVH by Framingham ECG score was most associated with CHD in blacks [HR (95%CI): 2.53 (1.65-3.89)], while LV strain showed the strongest association with CHD in whites [1.73 (1.18-2.56)]. No statistically significant improvement in NRI or C-statistic was observed in model 2 [C-statistic (95% CI): 0.779 (0.763-0.794), NRI = 0.006 (p = 0.41)], compared with the base model [0.777 (0.762-0.792)]; and no racial interactions were observed. Findings were unchanged when the base model was replaced with the 10 and 20-year ARIC risk model (includes diabetes) for CHD. Conclusions: In this cohort of black and white men and women, LVH (defined by ECG) was significantly associated with CHD after adjustment for FRS; but did not significantly improve CHD risk prediction beyond the FRS. No significant black-white differences in risk prediction were observed. Table. Reclassification of Coronary Heart Disease by the addition of each Criterion for Left Ventricular Hypertrophy, based on a 10-year Framingham Risk Model * Base model factors in age, gender, current smoking, diabetes, systolic blood pressure, diastolic blood pressure, HDL cholesterol and total cholesterol as separate variables. * NRI categorized as <10%, 10-20% and >20%. Abbreviations: NRI = Net Reclassification Index, IDI = Integrated Discrimination Index, HR = Hazard Ratio, CI = Confidence Interval

Standard ECG for differential diagnosis between Anderson-Fabry disease and hypertrophic cardiomyopathy

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318271
Author(s):  
Giovanni Vitale ◽  
Raffaello Ditaranto ◽  
Francesca Graziani ◽  
Ilaria Tanini ◽  
Antonia Camporeale ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hypertrophic Cardiomyopathy ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
St Depression ◽  
C Statistic ◽  
Pr Interval ◽  
Qrs Duration ◽  
Ecg Score

ObjectivesTo evaluate the role of the ECG in the differential diagnosis between Anderson-Fabry disease (AFD) and hypertrophic cardiomyopathy (HCM).MethodsIn this multicentre retrospective study, 111 AFD patients with left ventricular hypertrophy were compared with 111 patients with HCM, matched for sex, age and maximal wall thickness by propensity score. Independent ECG predictors of AFD were identified by multivariate analysis, and a multiparametric ECG score-based algorithm for differential diagnosis was developed.ResultsShort PR interval, prolonged QRS duration, right bundle branch block (RBBB), R in augmented vector left (aVL) ≥1.1 mV and inferior ST depression independently predicted AFD diagnosis. A point-by-point ECG score was then derived with the following diagnostic performances: c-statistic 0.80 (95% CI 0.74 to 0.86) for discrimination, the Hosmel-Lemeshow χ2 6.14 (p=0.189) for calibration, sensitivity 69%, specificity 84%, positive predictive value 82% and negative predictive value 72%. After bootstrap resampling, the mean optimism was 0.025, and the internal validated c-statistic for the score was 0.78.ConclusionsStandard ECG can help to differentiate AFD from HCM while investigating unexplained left ventricular hypertrophy. Short PR interval, prolonged QRS duration, RBBB, R in aVL ≥1.1 mV and inferior ST depression independently predicted AFD. Their systematic evaluation and the integration in a multiparametric ECG score can support AFD diagnosis.

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