Echocardiography Predictors of Survival in Hypertensive Patients With Left Ventricular Hypertrophy
| Autor: | Linsay McCallum, Anna F. Dominiczak, Tomasz J. Guzik, Krzysztof Zmudka, Bartlomiej M Guzik, Sandosh Padmanabhan |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Concentric hypertrophy Hemodynamics 030204 cardiovascular system & hematology Left ventricular hypertrophy Logistic regression Risk Assessment Muscle hypertrophy 03 medical and health sciences 0302 clinical medicine Internal medicine Internal Medicine medicine Humans Eccentric 030212 general & internal medicine Ventricular Remodeling business.industry medicine.disease Survival Analysis Target organ damage Blood pressure Echocardiography Hypertension Cardiology Hypertrophy Left Ventricular business |
| Zdroj: | American Journal of Hypertension. 34:636-644 |
| ISSN: | 1941-7225 0895-7061 |
| DOI: | 10.1093/ajh/hpaa194 |
| Popis: | BACKGROUND Left ventricular hypertrophy (LVH) is a well-known target organ damage. Concentric hypertrophy is the strongest predictor of increased risk of cardiovascular events, but the predictive value of individual echocardiographic parameters remains unclear. The aim of this study was to search for echocardiographic and hemodynamic variables associated with concentric and eccentric remodeling and their association with long-term cardiovascular outcomes. METHODS Patients with echocardiography performed within 1 year prior to the initial clinic visit were included into the study. Logistic regression and multivariable Cox-proportional hazards were calculated according to several risk factors and variables. Additionally, cubic spline interpolation was used. RESULTS We observed 690 patients for 10 years. There was a total of 177 major adverse cardiac and cerebrovascular events (MACCE) and 90 deaths over a 10-year period. Left ventricular concentric hypertrophy is associated with worse outcomes than eccentric hypertrophy in hypertensive subjects. Interestingly, different echocardiographic parameters contributed to risk depending on type of hypertrophy. In concentric hypertrophy, relative wall thickness provides linear prediction of risk for all-cause mortality (ACM) and composite endpoint. Systolic blood pressure is a significant predictor of MACCE. Blood pressure variability also showed significant predictive value for MACCE and ACM. CONCLUSIONS These data indicate risk stratification based on LVH need to consider different measures based on the type of remodeling. |
| Databáze: | OpenAIRE |
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