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Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction.

Publication ,  Journal Article
Velagaleti, RS; Gona, P; Pencina, MJ; Aragam, J; Wang, TJ; Levy, D; D'Agostino, RB; Lee, DS; Kannel, WB; Benjamin, EJ; Vasan, RS
Published in: Am J Cardiol
January 1, 2014

Higher left ventricular (LV) mass, wall thickness, and internal dimension are associated with increased heart failure (HF) risk. Whether different LV hypertrophy patterns vary with respect to rates and types of HF incidence is unclear. In this study, 4,768 Framingham Heart Study participants (mean age 50 years, 56% women) were classified into 4 mutually exclusive LV hypertrophy pattern groups (normal, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy) using American Society of Echocardiography-recommended thresholds of echocardiographic LV mass indexed to body surface area and relative wall thickness, and these groups were related to HF incidence. Whether risk for HF types (HF with reduced ejection fraction [<45%] vs preserved ejection fraction [≥45%]) varied by hypertrophy pattern was then evaluated. On follow-up (mean 21 years), 458 participants (9.6%, 250 women) developed new-onset HF. The age- and gender-adjusted 20-year HF incidence increased from 6.96% in the normal left ventricle group to 8.67%, 13.38%, and 15.27% in the concentric remodeling, concentric hypertrophy, and eccentric hypertrophy groups, respectively. After adjustment for co-morbidities and incident myocardial infarction, LV hypertrophy patterns were associated with higher HF incidence relative to the normal left ventricle group (p = 0.0002); eccentric hypertrophy carried the greatest risk (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.41 to 2.54), followed by concentric hypertrophy (HR 1.40, 95% CI 1.04 to 1.87). Participants with eccentric hypertrophy had a higher propensity for HF with reduced ejection fraction (HR 2.23, 95% CI 1.48 to 3.37), whereas those with concentric hypertrophy were more prone to HF with preserved ejection fraction (HR 1.66, 95% CI 1.09 to 2.51). In conclusion, in this large community-based sample, HF risk varied by LV hypertrophy pattern, with eccentric and concentric hypertrophy predisposing to HF with reduced and preserved ejection fraction, respectively.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

January 1, 2014

Volume

113

Issue

1

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • United States
  • Stroke Volume
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Hypertrophy, Left Ventricular
  • Humans
  • Heart Ventricles
  • Heart Failure
 

Citation

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Velagaleti, R. S., Gona, P., Pencina, M. J., Aragam, J., Wang, T. J., Levy, D., … Vasan, R. S. (2014). Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol, 113(1), 117–122. https://doi.org/10.1016/j.amjcard.2013.09.028
Velagaleti, Raghava S., Philimon Gona, Michael J. Pencina, Jayashri Aragam, Thomas J. Wang, Daniel Levy, Ralph B. D’Agostino, et al. “Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction.Am J Cardiol 113, no. 1 (January 1, 2014): 117–22. https://doi.org/10.1016/j.amjcard.2013.09.028.
Velagaleti RS, Gona P, Pencina MJ, Aragam J, Wang TJ, Levy D, et al. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014 Jan 1;113(1):117–22.
Velagaleti, Raghava S., et al. “Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction.Am J Cardiol, vol. 113, no. 1, Jan. 2014, pp. 117–22. Pubmed, doi:10.1016/j.amjcard.2013.09.028.
Velagaleti RS, Gona P, Pencina MJ, Aragam J, Wang TJ, Levy D, D’Agostino RB, Lee DS, Kannel WB, Benjamin EJ, Vasan RS. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014 Jan 1;113(1):117–122.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

January 1, 2014

Volume

113

Issue

1

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • United States
  • Stroke Volume
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Hypertrophy, Left Ventricular
  • Humans
  • Heart Ventricles
  • Heart Failure