The remodelling index risk stratifies patients with hypertensive left ventricular hypertrophy
Autor: | Boyang Su, Rositaa Ibrahim, Vanessa Lim, Thu-Thao Le, Muh-Tyng Teo, Briana Ang, Stuart A. Cook, Chi-Hang Lee, Jennifer Bryant, Jeroen J. Bax, Calvin W. L. Chin, Tar Choon Aw |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Heart Ventricles 030204 cardiovascular system & hematology Left ventricular hypertrophy Asymptomatic 030218 nuclear medicine & medical imaging Muscle hypertrophy 03 medical and health sciences cardiovascular magnetic resonance 0302 clinical medicine Internal medicine medicine Humans AcademicSubjects/MED00200 Radiology Nuclear Medicine and imaging Mass index cardiovascular diseases Adverse effect Ventricular Remodeling medicine.diagnostic_test business.industry cardiac remodelling Magnetic resonance imaging Original Articles General Medicine medicine.disease Hypertensive heart disease left ventricular hypertrophy Echocardiography Heart failure Hypertension Cardiology Hypertrophy Left Ventricular medicine.symptom Cardiology and Cardiovascular Medicine business hypertensive heart disease |
Zdroj: | European Heart Journal-Cardiovascular Imaging, 22(6), 670-679. OXFORD UNIV PRESS European Heart Journal Cardiovascular Imaging |
Popis: | Aims Hypertensive left ventricular hypertrophy (LVH) is associated with increased cardiovascular events. We previously developed the remodelling index (RI) that incorporated left ventricular (LV) volume and wall-thickness in a single measure of advanced hypertrophy in hypertensive patients. This study examined the prognostic potential of the RI in reference to contemporary LVH classifications. Methods and results Cardiovascular magnetic resonance was performed in 400 asymptomatic hypertensive patients. The newly derived RI (EDV3t, where EDV is LV end-diastolic volume and t is the maximal wall thickness across 16 myocardial segments) stratified hypertensive patients: no LVH, LVH with normal RI (LVHNormal-RI), and LVH with low RI (LVHLow-RI). The primary outcome was a composite of all-cause mortality, acute coronary syndromes, strokes, and decompensated heart failure. LVHLow-RI was associated with increased LV mass index, fibrosis burden, impaired myocardial function and elevated biochemical markers of myocardial injury (high-sensitive cardiac troponin I), and wall stress. Over 18.3 ± 7.0 months (601.3 patient-years), 14 adverse events occurred (2.2 events/100 patient-years). Patients with LVHLow-RI had more than a five-fold increase in adverse events compared to those with LVHNormal-RI (11.6 events/100 patient-years vs. 2.0 events/100 patient-years, respectively; log-rank P Conclusion The RI provides prognostic value that improves risk stratification of hypertensive LVH. |
Databáze: | OpenAIRE |
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