scholarly journals Echocardiographic left ventricular geometry profiles for prediction of stroke, coronary heart disease and all-cause mortality in the Chinese community: a rural cohort population study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tan Li ◽  
Guangxiao Li ◽  
Xiaofan Guo ◽  
Zhao Li ◽  
Yingxian Sun
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Left Ventricular Geometry ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy

Abstract Background The utility of echocardiographic left ventricular (LV) geometry in the prediction of stroke/coronary heart disease (CHD) and all-cause mortality is not well characterized. This study aimed to evaluate the overall and sex-specific prognostic value of different geometric patterns on the incidence of stroke/CHD and all-cause mortality in a Chinese population-based cohort. Methods We conducted a prospective study in the general population in Northeast China, and a total of 9940 participants aged ≥ 35 years underwent echocardiography for LV geometry and were successfully followed up for incident stroke/CHD and all-cause death. Cox proportional hazards models were utilized to estimate the association of baseline LV geometry with adverse outcomes. Results Over a median follow-up of 4.66 years, abnormal LV geometric patterns had increased crude incident rates of stroke/CHD and all-cause mortality compared with normal geometry in overall population and each sex group (all P < 0.05). Multivariable Cox analysis reported that LV concentric and eccentric hypertrophy were associated with incident stroke/CHD (concentric hypertrophy: hazard ratio (HR) = 1.39, 95% confidence interval (CI) = 1.04–1.86; eccentric hypertrophy: HR = 1.42, 95% CI = 1.11–1.82) and all-cause mortality (concentric hypertrophy: HR = 1.50, 95% CI = 1.07–2.12; eccentric hypertrophy: HR = 1.58, 95% CI = 1.19–2.10), and LV concentric remodeling was related to stroke/CHD incidence (HR = 1.42, 95% CI = 1.09–1.84) in total population compared to normal geometry after the adjustment for potential confounders. In men, a significant increase was observed from LV eccentric hypertrophy for incident stroke/CHD, whereas in women, LV concentric hypertrophy was associated with elevated incidence of both stroke/CHD and all-cause death, and eccentric hypertrophy was correlated with increased all-cause mortality (all P < 0.05). Conclusions Our prospective cohort supports that abnormal LV geometry by echocardiography has a prognostic significance for incident stroke/CHD and all-cause mortality, implying that early detection and intervention of LV structural remodeling in rural China are urgently needed to prevent adverse outcomes.

scholarly journals Sex-specific relationships between patterns of ventricular remodelling and clinical outcomes

2020 ◽  
Vol 21 (9) ◽  
pp. 983-990 ◽  
Author(s):  
Robert J H Miller ◽  
Yoko Mikami ◽  
Bobak Heydari ◽  
Stephen B Wilton ◽  
Matthew T James ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Clinical Outcomes ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Prognostic Information ◽  
Concentric Hypertrophy ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy ◽  
Myocardial Remodelling

Abstract Aims Left ventricular hypertrophy (LVH) is the most common form of myocardial remodelling and predicts adverse outcomes in patients with coronary artery disease (CAD). However, sex-specific prevalence and prognostic significance of LVH patterns are poorly understood. We investigated the sex-specific influence of LVH pattern on clinical outcomes in patients undergoing cardiovascular magnetic resonance (CMR) and coronary angiography following adjustment for co-morbidities including CAD burden. Methods and results Patients undergoing CMR and coronary angiography between 2005 and 2013 were included. Volumetric measurements of left ventricular (LV) mass with classification of concentric vs. eccentric remodelling patterns were determined from CMR cine images. Multivariable Cox analysis was performed to assess independent associations with the primary outcome of all-cause mortality. In total, 3754 patients were studied (mean age 59.3 ± 13.1 years), including 1039 (27.7%) women. Women were more likely to have concentric remodelling (8.1% vs. 2.1%, P &lt; 0.001), less likely to have eccentric hypertrophy (15.1% vs. 26.8%, P &lt; 0.001) and had a similar prevalence of concentric hypertrophy (6.1 vs. 5.2%, P = 0.296) compared to men. At a median follow-up of 3.7 years, 315 (8.4%) patients died. Following adjustment including CAD burden, concentric hypertrophy was associated with increased all-cause mortality in women [adjusted hazard ratio (HR) 3.48, P &lt; 0.001] and men (adjusted HR 2.57, P &lt; 0.001). Eccentric hypertrophy was associated with all-cause mortality only in women (adjusted HR 1.78, P = 0.047). Conclusion Patterns of LV remodelling differ by sex and LVH and provides prognostic information in both men and women. Our findings support the presence of sex-specific factors influencing LV remodelling.

scholarly journals Echocardiographic Assessment of Left Ventricular Geometric Patterns in Hypertensive Patients in Nigeria

2013 ◽  
Vol 7 ◽  
pp. CMC.S12727 ◽  
Author(s):  
Rasaaq A. Adebayo ◽  
Olaniyi J. Bamikole ◽  
Michael O. Balogun ◽  
Anthony O. Akintomide ◽  
Victor O. Adeyeye ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Geometric Pattern ◽  
Color Flow ◽  
Hypertensive Patients ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Lv Systolic Function

Left ventricular (LV) hypertrophy is an important predictor of morbidity and mortality in hypertensive patients, and its geometric pattern is a useful determinant of severity and prognosis of heart disease. Studies on LV geometric pattern involving large number of Nigerian hypertensive patients are limited. We examined the LV geometric pattern in hypertensive patients seen in our echocardiographic laboratory. A two-dimensional, pulsed, continuous and color flow Doppler echocardiographic evaluation of 1020 consecutive hypertensive patients aged between 18 and 91 years was conducted over an 8-year period. LV geometric patterns were determined using the relationship between the relative wall thickness and LV mass index. Four patterns of LV geometry were found: 237 (23.2%) patients had concentric hypertrophy, 109 (10.7%) had eccentric hypertrophy, 488 (47.8%) had concentric remodeling, and 186 (18.2%) had normal geometry. Patients with concentric hypertrophy were significantly older in age, and had significantly higher systolic blood pressure (BP), diastolic BP, and pulse pressure than those with normal geometry. Systolic function index in patients with eccentric hypertrophy was significantly lower than in other geometric patterns. Doppler echocardiographic parameters showed some diastolic dysfunction in hypertensive patients with abnormal LV geometry. Concentric remodeling was the most common LV geometric pattern observed in our hypertensive patients, followed by concentric hypertrophy and eccentric hypertrophy. Patients with concentric hypertrophy were older than those with other geometric patterns. LV systolic function was significantly lower in patients with eccentric hypertrophy and some degree of diastolic dysfunction were present in patients with abnormal LV geometry.

Abstract P092: Longitudinal Impact Of Blood Pressure On Left Ventricular Geometry In The Hispanic Community Health Study/Study Of Latinos: Echocardiographic Study Of Latinos (Echo-SOL) Ancillary Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jennifer McLeod ◽  
Barry E Hurwitz ◽  
Daniela Sotres-Alvarez ◽  
Mayank M Kansal ◽  
Katrina Swett ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular ◽  
Health Study ◽  
Left Ventricular Geometry ◽  
Longitudinal Impact ◽  
Ventricular Geometry ◽  
Concentric Hypertrophy ◽  
Echocardiographic Study ◽  
Eccentric Hypertrophy ◽  
Latino Adults

Introduction: Abnormal left ventricular geometry (LVG) is an independent predictor of cardiovascular mortality. We assessed the longitudinal transitions of LVG among Hispanic/Latino adults. Methods: Echo-SOL provided serial 2D echocardiograms of Hispanic adults. Each subject was identified as hypertensive or normotensive and categorized into four LVG patterns: normal, concentric remodeling (CR), concentric hypertrophy (CH), or eccentric hypertrophy (EH). Hypertensive adults were stratified on whether they maintained blood pressure (BP) control (<140/90mmHg) by visit 2. The normotensive adults were stratified on whether they developed incident hypertension (HTN) by visit 2. Logistic regression was used to evaluate the outcome of normal vs. abnormal LVG at visit 2 adjusting for age, sex, and follow-up time. Results: There were 1818 adults at visit 1 (mean age 56 years; 42.6% male, 44.7% hypertensive), with 1643 obtaining serial echocardiograms an average of 4.3 years later. At visit 1, LVG was distributed as follows: normal, 65.3%; CR, 30.6%, CH 3.1%, and EH 1.1%. Among hypertensive adults at visit 1, 59.7% had normal LVG and 34.1% had CR. By visit 2, there was a progression from normal LVG to CR among those with and without BP control; CR prevalence increased to 58.5% and 55.2%, respectively (Fig. 1). For visit 1 hypertensive adults, the incidence of abnormal LVG did not differ with regards to BP control (adjusted OR 1.1, 95% CI: 0.7-1.7). Among normotensive adults at visit 1, 69.8% had normal LVG. If they remained normotensive by visit 2, this prevalence decreased to 52.2%. If they developed HTN, there was an associated progression toward abnormal geometry (adjusted OR 2.5, 95% CI: 1.4-4.2), with the majority (59.2%) demonstrating a CR phenotype. Conclusion: Our findings suggest that BP control to 140mmHg is not adequate to prevent progressive LV remodeling among Hispanic/Latino adults. Further study is needed to understand this maladaptive process and how it contributes to cardiovascular disease in this population.

Cardiac response to pressure overload in 129S1/SvImJ and C57BL/6J mice: temporal- and background-dependent development of concentric left ventricular hypertrophy

2007 ◽  
Vol 292 (5) ◽  
pp. H2119-H2130 ◽  
Author(s):  
Cordelia J. Barrick ◽  
Mauricio Rojas ◽  
Robert Schoonhoven ◽  
Susan S. Smyth ◽  
David W. Threadgill
Keyword(s):  
Heart Failure ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Pressure Overload ◽  
Left Ventricular ◽  
Cardiac Response ◽  
Dependent Manner ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy

Left ventricular hypertrophy (LVH), a risk factor for cardiovascular morbidity and mortality, is commonly caused by essential hypertension. Three geometric patterns of LVH can be induced by hypertension: concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Clinical studies suggest that different underlying etiologies, genetic modifiers, and risk of mortality are associated with LVH geometric patterns. Since pressure overload-induced LVH can be modeled experimentally using transverse aortic constriction (TAC) and since C57BL/6J (B6) and 129S1/SvImJ (129S1) strains, which have different baseline cardiovascular phenotypes, are commonly used, we conducted serial echocardiographic studies to assess cardiac function up to 8 wk of post-TAC in male B6, 129S1, and B6129F1 (F1) mice. B6 mice had an earlier onset and more pronounced impairment in contractile function, with corresponding left and right ventricular dilatation, fibrosis, change in expression of hypertrophy marker, and increased liver weights at 5 wk of post-TAC. These observations suggest that B6 mice had eccentric hypertrophy with systolic dysfunction and right-sided heart failure. In contrast, we found that 129S1 and F1 mice delayed transition to decompensated heart failure, with 129S1 mice exhibiting preserved systolic function until 8 wk of post-TAC and relatively mild alterations in histology and markers of hypertrophy at 5 wk post-TAC. Consistent with concentric hypertrophy, our results show that these strains manifest different cardiac responses to pressure overload in a time-dependent manner and that genetic susceptibility to initial concentric hypertrophy is dominant to eccentric hypertrophy. These results also imply that genetic background differences can complicate interpretation of TAC studies when using mixed genetic backgrounds.

scholarly journals 5-YEAR DYNAMICS OF FEATURES OF LEFT VENTRICULAR GEOMETRY IN PATIENTS WITH ISCHEMIC HEART DISEASE, DEPENDING ON TREATMENT TACTICS

2019 ◽  
Vol 19 (3) ◽  
pp. 17-21
Author(s):  
R.R. Guta ◽  
N.S. Beck ◽  
O.M. Radchenko
Keyword(s):  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Comparison Group ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry ◽  
Concentric Left Ventricular Hypertrophy ◽  
Eccentric Hypertrophy

Introduction. For a patient with coronary heart disease, recovery from myocardial revascularization is a complex process. Cardiac remodeling involves, after myocardial infarction, hypertrophy and dilation, resulting in impaired systolic-diastolic cardiac function, which is an additional risk factor for events. Prospective studies have shown a relationship between left ventricular size and the risk of cardiovascular events. Given this, there was a need to conduct our research. Purpose: To determine the prevalence of types of left ventricular geometry in patients with coronary heart disease, post-infarction cardiosclerosis, depending on therapeutic tactics: revascularization or conservative therapy for 60 months. Material and Methods: We examined 101 patients aged 58.6±4.2 years after myocardial revascularization (n = 71) and with conservative treatment only (n = 30), in whom the dynamics of echocardiographic parameters of the heart were evaluated for 5 years. The values ​​of remodeling myocardial mass index of the left ventricle and the relative thickness of the left ventricle were determined. Results and Discussion. At baseline, patients with concentric left ventricular hypertrophy (50.0%) and concentric remodeling (24.1%) predominated in the main group. Normal geometry in 14.8% and eccentric left ventricular hypertrophy were observed in 11.1%. In the comparison group, eccentric hypertrophy and concentric left ventricular remodeling were most commonly observed, 29.6% each, slightly less than 25.9% concentric hypertrophy, and the least was normal geometry (14.8%). After 60 months, patients with both groups did not experience normal left ventricular geometry and concentric remodeling. The concentric type (80.0%) was predominant in the main group, and the eccentric type (55.6%) in the comparison group. Conclusions. In patients with ischemic heart disease, postinfarction cardiosclerosis progresses in 5 year follow-up myocardial hypertrophy regardless of treatment. After revascularization, concentric left ventricular hypertrophy develops more often, whereas under conservative treatment, left ventricular eccentric hypertrophy is combined with systolic dysfunction and left atrial dilatation. After revascularization, an increase in the index was associated with an increase not only in body weight but also in changes in lipid profile and diastolic hypertension.

Abstract 3154: Interacton of Left Ventricular Geometry and Cardiovascular Hemodynamics in 57,307 Patients wth Preserved Ejection Fraction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Richard V Milani ◽  
Carl J Lavie
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Prognostic Impact ◽  
Preserved Ejection Fraction ◽  
Cardiovascular Hemodynamics ◽  
Non Invasive ◽  
Concentric Hypertrophy ◽  
Echocardiographic Evaluation ◽  
Eccentric Hypertrophy

We and others have demonstrated the prognostic impact of LV geometry on subsequent survival in patients with preserved ejection. The purpose of this investigation was to describe parameters of cardiovascular hemodynamics and energetics associated with normal and abnormal LV geometry, including concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH) fraction in patients who were referred for routine echocardiographic evaluation. Measures were obtained using standard non-invasive methods previously reported. Survival was obtained by the National Death Index after a mean follow-up of 2.8 years. Conclusion: Changes in LV geometry are associated with significant abnormalities in cardiac and vascular hemodynamics and energetics that in general progress from CR to frank hypertrophy. Intervention directed towards modifying these parameters are needed in order to evaluate the potential for improving clinical outcomes.

Abstract P274: FGF-23 is Associated with Left Ventricular Hypertrophy and Systolic Dysfunction among Patients with Coronary Heart Disease: The Heart and Soul Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Isha Agarwal ◽  
Joachim Ix ◽  
Bryan Kestenbaum ◽  
Nelson Schiller ◽  
Mary Whooley ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Left Ventricular Mass ◽  
Kidney Function ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Concentric Hypertrophy ◽  
Fgf 23

Introduction: Fibroblast growth factor-23 (FGF-23) is a bone-derived phosphaturic hormone strongly associated with cardiovascular mortality and left ventricular hypertrophy among individuals with end-stage renal disease (ESRD). Whether the relationship between FGF-23 and cardiac dysfunction extends to participants without ESRD is not clearly established. Hypothesis: We tested whether FGF-23 is associated with left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in participants with coronary heart disease (CHD) and a broad range of kidney function in the Heart and Soul Study. Methods and Results: In cross-sectional analyses of 887 participants of the Heart and Soul Study, FGF-23 was positively associated with LVMI (2.09 g/m 2 , 95% confidence interval [CI] 0.15 to 4.03 per 1 standard-deviation [SD] higher ln FGF-23) and inversely associated with LVEF (-0.96%, CI -1.71% to -0.21%, per 1 SD higher ln FGF-23) after adjustment for age, CHD risk factors, microalbuminuria, and cystatin-based estimated glomerular filtration rate (eGFR). In multinomial logistic regression, FGF-23 was associated with an increased prevalence of concentric hypertrophy (odds ratio 1.66, CI 1.00 to 2.76, per 1 SD increase in ln FGF-23) but not eccentric hypertrophy (odds ratio 1.14, CI 0.96 to 1.36). The association between FGF-23 and concentric hypertrophy was stronger among individuals with an estimated GFR < 60 mL/min per 1.73 m 2 , and was not statistically significant among individuals with normal to mildly reduced kidney function (Figure, p interaction 0.11). Conclusion: In conclusion, FGF-23 was associated with greater left ventricular mass and concentric hypertrophy, particularly among individuals with diminished kidney function. Additional studies are necessary to determine the pathways that mediate this association.

scholarly journals Sex differences in left ventricular remodeling in patients with severe aortic valve stenosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J H Kuneman ◽  
G K Singh ◽  
S Milhorini Pio ◽  
K Hirasawa ◽  
N Ajmone Marsan ◽  
...  
Keyword(s):  
Sex Differences ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Left Ventricular ◽  
Concentric Hypertrophy ◽  
Lv Mass ◽  
Lv Remodeling ◽  
All Cause Mortality ◽  
Eccentric Hypertrophy ◽  
Lv Volumes

Abstract Background Women with severe aortic valve stenosis (AS) have better long-term outcomes after transcatheter aortic valve implantation (TAVI) but worse survival after surgical aortic valve replacement compared to men. Whether this is related to sex differences in left ventricular (LV) remodeling is unknown. Purpose To examine sex differences in LV remodeling and outcomes in patients with severe AS undergoing TAVI. Methods Patients with severe AS who underwent TAVI between 2007 and 2018 with a pre-procedural multidetector row computed tomography (MDCT) scan were included. LV volumes, mass and function were analyzed with MDCT. Patients were classified into 4 LV remodeling patterns based on LV mass index and LV mass-to-volume ratio: 1) normal geometry, 2) concentric remodeling, 3) concentric hypertrophy and 4) eccentric hypertrophy. The primary endpoint was all-cause mortality after TAVI. Results A total of 289 patients (age 80±6 years, 54% male) were included. Women showed smaller LV volumes and mass compared to men. Concentric hypertrophy (50%) was the most frequent pattern of LV remodeling followed by eccentric hypertrophy (33%), normal geometry (13%) and concentric remodeling (4%). Concentric remodeling was more frequently observed in men compared to women (91% vs. 9% respectively, p=0.011). However, no sex differences were observed in the remaining LV remodeling patterns (Figure 1). During a median follow-up of 3.8 (IQR 2.2–5.1) years after TAVI, 87 patients died. Women demonstrated better outcome after TAVI compared to men (log-rank χ2=4.29, p=0.038). The survival benefit of women over men was mainly present among patients with concentric hypertrophy (log-rank χ2=4.91, p=0.027, Figure 2). Conclusion LV concentric and eccentric hypertrophy are similarly observed in men and women with severe AS. Women demonstrated better outcome after TAVI as compared to men, particularly among those with LV concentric hypertrophy. However, the outcome benefit of females after TAVI seems not to be related to sex-differences in LV remodeling. FUNDunding Acknowledgement Type of funding sources: None. Distribution of sex in LV remodeling All-cause mortality after TAVI

Sign in / Sign up

Export Citation Format

Share Document