Patterns of left ventricular remodeling in chronic heart failure: prevalence and prognostic implications
| Autor: | Frank Lloyd Dini, Mario Marzilli, Anca Irina Corciu, Anca Simioniuc, Paola Capozza, Andrea Pieroni, Francesca Donati, Paolo Fontanive, Vitantonio Di Bello |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Diastole Comorbidity Kaplan-Meier Estimate Internal medicine medicine Humans Mass index Interventricular septum Ventricular remodeling Aged Proportional Hazards Models Heart Failure Ejection fraction Ventricular Remodeling business.industry Stroke Volume Stroke volume medicine.disease Prognosis Echocardiography Doppler medicine.anatomical_structure ROC Curve Heart failure Chronic Disease Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | American heart journal. 161(6) |
| ISSN: | 1097-6744 |
| Popis: | Many descriptors of left ventricular (LV) remodeling have important prognostic implications in patients with chronic systolic heart failure (HF). We sought to assess the prognostic value of the combination of increased LV mass with a disproportion between wall thickness and internal diameter.Patients (n = 536) with chronic HF, ejection fraction50% and LV end-diastolic volume index91 mL/m(2), classified according to LV mass index and relative wall thickness (RWT), were followed up for 33 ± 21 months. Ventricular mass was determined using a standard M-mode echocardiographic method. Relative wall thickness was defined as the ratio of (sum of interventricular septum thickness in diastole + posterior wall thickness in diastole)/LV end-diastolic diameter.Prevalence of the pattern of increased LV mass index, defined as LV mass index148 g/m(2) in men and122 g/m(2) in women, and decreased RWT (0.34) was 29%. Multivariable predictors of all-cause mortality were age70 years (P.0001), New York Heart Association class2 (P.0001), increased LV mass index, and decreased RWT (P = .003), E wave deceleration time ≤140 ms (P = .005), and male gender (P = .025). Patients with increased LV mass index and decreased RWT had a worse survival (33%) than patients with less LV mass index and normal to reduced RWT (log-rank 23.92; P.0001). Comparisons of Cox models showed that the combination of increased mass index and decreased RWT added prognostic value to a model that included ejection fraction and end-systolic volume index.In patients with systolic HF, an independent and incremental risk of adverse outcome was associated with increased mass index and decreased RWT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect