Relation of Left Ventricular Hypertrophy Subtype to Long-Term Mortality in Those With Subclinical Cardiovascular Disease (From the Multiethnic Study of Atherosclerosis [MESA])

Authors

Edward T. Ha, Department of Internal Medicine and Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York.
Alexander Ivanov, Department of Cardiology, Atrium Health Wake Forest Baptist Health, Winston-Salem, North Carolina. Electronic address: aivanov@wakehealth.edu.
Joseph Yeboah, Department of Cardiology, Atrium Health Wake Forest Baptist Health, Winston-Salem, North Carolina.
Austin Seals, Department of Cardiology, Atrium Health Wake Forest Baptist Health, Winston-Salem, North Carolina.
Stephen J. Peterson, Department of Internal Medicine and Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
Manish Parikh, Department of Internal Medicine and Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
Wilbert S. Aronow, Department of Internal Medicine, New York Medical College, Valhalla, New York.Follow
William H. Frishman, Department of Internal Medicine, New York Medical College, Valhalla, New York.Follow

Author Type(s)

Faculty

DOI

10.1016/j.amjcard.2022.03.058

Journal Title

The American Journal of Cardiology

First Page

131

Last Page

138

Document Type

Article

Publication Date

7-15-2022

Department

Medicine

Abstract

The clinical and biochemical profile of differing Left ventricular hypertrophy phenotypes and its effect on long-term outcomes is ill-defined. The study investigated the differences in risk profiles and prognostic effect of concentric (CH) and eccentric hypertrophy (EH) on long-term adverse outcomes in a contemporary, ethnically diverse cohort. We analyzed follow-up data over 15 years from the Multiethnic Study of Atherosclerosis study. A total of 4,979 participants with cardiac magnetic resonance performed at baseline enrollment were included. Descriptive statistics, Kaplan-Meier curves, and regression models were applied. Independent variables associated with CH were black and Hispanic race/ethnicity, systolic blood pressure, and metabolic syndrome. Independent variables associated with EH were systolic blood pressure and urine creatinine, whereas serum creatinine had an inverse association. The primary end point of all-cause death (n = 1,137, 22.8%) occurred in 21.7%, 47.4%, and 56.6% of participants with no, CH, or EH, respectively (p- < 0.001). Age (hazard ratio [HR] per year = 1.10 [1.09 to 1.11], p <0.001), male gender (HR = 1.48 [1.29 to 1.69], p <0.001), black race (HR = 1.17 [1.005 to 1.36], p = 0.04), fasting glucose (HR = 1.005 [1.003 to 1.007], p <0.001), baseline creatinine (HR per mg/100 ml = 1.29 [1.15 to 1.46], p <0.001), left ventricular ejection fraction (HR per 1% = 0.98 [0.98 to 0.99], p = 0.005), IL-6 (HR per pg/ml = 1.17 [1.12 to 1.22], p <0.001), CH (HR = 1.84 [1.41 to 2.41], p <0.001), and EH (HR = 2.58 [1.77 to 3.76], p <0.001) were significant predictors of all-cause mortality. In conclusion, CH and EH are 2 distinct clinical phenotypes of left ventricular hypertrophy with differing gender and racial predisposition, both of which are associated with worse long-term adverse outcomes.

Recommended Citation

Ha, E. T., Ivanov, A., Yeboah, J., Seals, A., Peterson, S. J., Parikh, M., Aronow, W. S., & Frishman, W. H. (2022). Relation of Left Ventricular Hypertrophy Subtype to Long-Term Mortality in Those With Subclinical Cardiovascular Disease (From the Multiethnic Study of Atherosclerosis [MESA]). The American Journal of Cardiology, 175, 131-138. https://doi.org/10.1016/j.amjcard.2022.03.058