Abstract
Background Data on the prognostic value of echocardiographic left ventricular (LV) hypertrophy (LVH) as defined by LV wall thickness rather than LV mass estimate are scarce and not univocal. Thus, we investigated the value of LV mass index, wall thickness, and relative wall thickness (RWT) in predicting cardiovascular events in the PAMELA population. methods At entry 1,716 subjects underwent diagnostic tests, including laboratory investigations, 24-hour ambulatory blood pressure (BP) monitoring, and echocardiography. For the purpose of this analysis, all subjects were divided into quintiles of LV mass, LV mass/ body surface area (BSA), LV mass/height2.7, interventricular septum (IVS), posterior wall (PW) thickness, IVS+PW thickness, and RWT. results Over a follow-up of 148 months, 139 nonfatal or fatal cardiovascular events were documented. After adjustment for age, sex, BP, fasting blood glucose, total cholesterol, and use of antihypertensive drugs, only the subjects stratified in the highest quintiles of LV mass indexed to body surface area (BSA) or height2.7 exhibited a greater likelihood of incident cardiovascular disease (relative risk (RR) = 2.72, 95% confidence interval (CI) = 1.05-7.00, P = 0.03; RR = 4.83, 95% CI = 1.45-16.13, P = 0.01, respectively) as compared with the first quintile (reference group). The same was not true for the highest quintiles of IVS, PW thickness, IVS+PW thickness, and RWT. Similar findings were found when echocardiographic parameters were expressed as continuous variables. conclusions This study indicates that LV wall thickness, different from LV mass index, does not provide a reliable estimate of cardiovascular risk associated with LVH in a general population. From these data it is recommended that echocardiographic laboratories should provide a systematic estimate of LV mass index, which is a strong, independent predictor of incident cardiovascular disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1079-1086 |
| Number of pages | 8 |
| Journal | American Journal of Hypertension |
| Volume | 27 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Blood pressure
- Cardiovascular prognosis
- Echocardiography
- Hypertension
- Left ventricular mass
- Wall thickness
ASJC Scopus subject areas
- Internal Medicine
- Medicine(all)
Cite this
Differential value of left ventricular mass index and wall thickness in predicting cardiovascular prognosis : Data from the PAMELA population. / Cuspidi, Cesare; Facchetti, Rita; Bombelli, Michele; Sala, Carla; Grassi, Guido; Mancia, Giuseppe.
In: American Journal of Hypertension, Vol. 27, No. 8, 2014, p. 1079-1086.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Differential value of left ventricular mass index and wall thickness in predicting cardiovascular prognosis
T2 - Data from the PAMELA population
AU - Cuspidi, Cesare
AU - Facchetti, Rita
AU - Bombelli, Michele
AU - Sala, Carla
AU - Grassi, Guido
AU - Mancia, Giuseppe
PY - 2014
Y1 - 2014
N2 - Background Data on the prognostic value of echocardiographic left ventricular (LV) hypertrophy (LVH) as defined by LV wall thickness rather than LV mass estimate are scarce and not univocal. Thus, we investigated the value of LV mass index, wall thickness, and relative wall thickness (RWT) in predicting cardiovascular events in the PAMELA population. methods At entry 1,716 subjects underwent diagnostic tests, including laboratory investigations, 24-hour ambulatory blood pressure (BP) monitoring, and echocardiography. For the purpose of this analysis, all subjects were divided into quintiles of LV mass, LV mass/ body surface area (BSA), LV mass/height2.7, interventricular septum (IVS), posterior wall (PW) thickness, IVS+PW thickness, and RWT. results Over a follow-up of 148 months, 139 nonfatal or fatal cardiovascular events were documented. After adjustment for age, sex, BP, fasting blood glucose, total cholesterol, and use of antihypertensive drugs, only the subjects stratified in the highest quintiles of LV mass indexed to body surface area (BSA) or height2.7 exhibited a greater likelihood of incident cardiovascular disease (relative risk (RR) = 2.72, 95% confidence interval (CI) = 1.05-7.00, P = 0.03; RR = 4.83, 95% CI = 1.45-16.13, P = 0.01, respectively) as compared with the first quintile (reference group). The same was not true for the highest quintiles of IVS, PW thickness, IVS+PW thickness, and RWT. Similar findings were found when echocardiographic parameters were expressed as continuous variables. conclusions This study indicates that LV wall thickness, different from LV mass index, does not provide a reliable estimate of cardiovascular risk associated with LVH in a general population. From these data it is recommended that echocardiographic laboratories should provide a systematic estimate of LV mass index, which is a strong, independent predictor of incident cardiovascular disease.
AB - Background Data on the prognostic value of echocardiographic left ventricular (LV) hypertrophy (LVH) as defined by LV wall thickness rather than LV mass estimate are scarce and not univocal. Thus, we investigated the value of LV mass index, wall thickness, and relative wall thickness (RWT) in predicting cardiovascular events in the PAMELA population. methods At entry 1,716 subjects underwent diagnostic tests, including laboratory investigations, 24-hour ambulatory blood pressure (BP) monitoring, and echocardiography. For the purpose of this analysis, all subjects were divided into quintiles of LV mass, LV mass/ body surface area (BSA), LV mass/height2.7, interventricular septum (IVS), posterior wall (PW) thickness, IVS+PW thickness, and RWT. results Over a follow-up of 148 months, 139 nonfatal or fatal cardiovascular events were documented. After adjustment for age, sex, BP, fasting blood glucose, total cholesterol, and use of antihypertensive drugs, only the subjects stratified in the highest quintiles of LV mass indexed to body surface area (BSA) or height2.7 exhibited a greater likelihood of incident cardiovascular disease (relative risk (RR) = 2.72, 95% confidence interval (CI) = 1.05-7.00, P = 0.03; RR = 4.83, 95% CI = 1.45-16.13, P = 0.01, respectively) as compared with the first quintile (reference group). The same was not true for the highest quintiles of IVS, PW thickness, IVS+PW thickness, and RWT. Similar findings were found when echocardiographic parameters were expressed as continuous variables. conclusions This study indicates that LV wall thickness, different from LV mass index, does not provide a reliable estimate of cardiovascular risk associated with LVH in a general population. From these data it is recommended that echocardiographic laboratories should provide a systematic estimate of LV mass index, which is a strong, independent predictor of incident cardiovascular disease.
KW - Blood pressure
KW - Cardiovascular prognosis
KW - Echocardiography
KW - Hypertension
KW - Left ventricular mass
KW - Wall thickness
UR - http://www.scopus.com/inward/record.url?scp=84905865317&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84905865317&partnerID=8YFLogxK
U2 - 10.1093/ajh/hpu019
DO - 10.1093/ajh/hpu019
M3 - Article
C2 - 24610896
AN - SCOPUS:84905865317
VL - 27
SP - 1079
EP - 1086
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 8
ER -