Incremental prognostic value of a complex left ventricular remodeling classification in asymptomatic for heart failure hypertensive patients
| Autor: | Maria Francesca Romano, Nicola Riccardo Pugliese, Stefano Taddei, Salvatore La Carrubba, Enrico Calogero, Frank Benedetto, Lorenzo Conte, Simona Buralli, Francesco Antonini-Canterin, Iacopo Fabiani, Vitantonio Di Bello, Scipione Carerj, Paolo Colonna, Valentina Barletta |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty hypertension Heart Ventricles Myocardial Infarction Concentric hypertrophy Blood Pressure Pulmonary Edema Kaplan-Meier Estimate 030204 cardiovascular system & hematology Asymptomatic Muscle hypertrophy 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Internal Medicine Humans 030212 general & internal medicine Myocardial infarction Ventricular remodeling ejection fraction Antihypertensive Agents Aged Retrospective Studies remodeling Heart Failure Ejection fraction Ventricular Remodeling Echocardiography Cardiology and Cardiovascular Medicine business.industry Stroke Volume Middle Aged medicine.disease Prognosis Blood pressure Heart failure Cardiology Female Hypertrophy Left Ventricular medicine.symptom business Follow-Up Studies |
| Popis: | We evaluated the prognostic impact of a complex remodeling classification (CRC) in asymptomatic patients with arterial hypertension (AH). We retrospectively included 749 hypertensive patients (female 325, 43.4% age 62 ± 11.3 years) in Stages A and B of heart failure. CRC was evaluated including indexed left ventricular mass, end-diastolic volume, and relative wall thickness. After 45-month follow-up, we considered a composite endpoint: total mortality, myocardial infarction, myocardial revascularization, cerebrovascular events, and acute pulmonary edema. Blood pressure was controlled in 265 patients (35.4%), 317 (42.3%) were in Grade 1 of AH, 123 (16.4%) in Grade 2, and 44 (5.9%) in Grade 3. Considering CRC, 292 patients (38%) presented normal/physiological hypertrophy, 102 (13.6%) concentric remodeling, 29 (3.9%) eccentric remodeling, 157 (21%) concentric hypertrophy, 11 (1.5%) mixed hypertrophy, 52 (6.9%) dilated hypertrophy, and 36 (4.8%) eccentric hypertrophy. We observed a total of 73 events (9.7%). Kaplan-Meier method demonstrated a significant different survival in CRC-derived classes (P .001). Cox regression demonstrated CRC as independent predictor (P = .01), after adjusting for age, gender, diabetes mellitus, grade of hypertension, antihypertensive therapy, stable ischemic heart disease, obesity, systolic and diastolic dysfunction, and classic remodeling classification. In asymptomatic patients with AH, CRC is an independent predictor of poor outcome. |
| Databáze: | OpenAIRE |
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