Differential value of left ventricular mass index and wall thickness in predicting cardiovascular prognosis: Data from the PAMELA population

Cesare Cuspidi, Rita Facchetti, Michele Bombelli, Carla Sala, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1079-1086
Number of pages8
JournalAmerican Journal of Hypertension
Volume27
Issue number8
DOIs
Publication statusPublished - 2014

Fingerprint

Body Surface Area
Cardiovascular Diseases
Confidence Intervals
Population
Ambulatory Blood Pressure Monitoring
Left Ventricular Hypertrophy
Routine Diagnostic Tests
Hypertrophy
Antihypertensive Agents
Echocardiography
Blood Glucose
Fasting
Cholesterol
Blood Pressure

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 journalArticle

@article{ce86e61b8e124c1eb76221d410df6032,
title = "Differential value of left ventricular mass index and wall thickness in predicting cardiovascular prognosis: Data from the PAMELA population",
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.",
keywords = "Blood pressure, Cardiovascular prognosis, Echocardiography, Hypertension, Left ventricular mass, Wall thickness",
author = "Cesare Cuspidi and Rita Facchetti and Michele Bombelli and Carla Sala and Guido Grassi and Giuseppe Mancia",
year = "2014",
doi = "10.1093/ajh/hpu019",
language = "English",
volume = "27",
pages = "1079--1086",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "8",

}

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 -