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
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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