Left ventricular hypertrophy reclassification and death: application of the Recommendation of the American Society of Echocardiography/European Association of Echocardiography.

نویسندگان

  • Andrea Barbieri
  • Francesca Bursi
  • Francesca Mantovani
  • Chiara Valenti
  • Michele Quaglia
  • Elena Berti
  • Massimiliano Marino
  • Maria Grazia Modena
چکیده

AIMS Despite the American Society of Echocardiography (ASE)/European Association of Echocardiography (EAE) recommended the use of left ventricular (LV) mass to diagnose left ventricular hypertrophy (LVH), several laboratories continue to use only the septal thickness by M-mode because it appears easier to measure. Aim of the study was to investigate the discrepancy between the categorization of LVH severity based on measurement of septal thickness and indexed LV mass and the relative prognostic utility of these two methods. METHODS AND RESULTS Observational cohort study. Unselected adults (>18 years) referred to the echocardiography laboratory for any indication had septal thickness and LV mass measured by the ASE/EAE formula using LV linear dimensions indexed to body surface area. LVH was categorized as absent, mild, moderate, and severe according to the ASE/EAE guideline sex-specific categorization cut-offs for septal thickness and LV mass. Follow-up for death was obtained from the national death index. A total of 2545 subjects (mean age 61.9 ± 15.8, 53% women, mean diastolic septal thickness 10.3 ± 2.2 mm, and mean indexed LV mass 107.5 ± 37.3 g/m(2)) were enrolled. Agreement between the two methods in classifying LVH degree across the four categories was 52.6% (Kappa = 0.29, 95% confidence interval (CI): 0.26-0.32, P < 0.001). Of the 2513 subjects without severely thickened septum, 472 (18.9%) had severely abnormal indexed LV mass. Vice versa, of the 2045 individuals without severely abnormal indexed LV mass, only 4 (0.1%) were classified as severe LVH by septal thickness. After a mean follow-up of 2.5 ± 1.2 years 121 (4.7%) deaths occurred. Using indexed LV mass partition values there was a graded association between LVH degree and survival. Compared with patients with normal indexed LV mass, the adjusted hazard ratio (HR) for death from all causes was 2.17 for mild (95% CI: 1.23-3.81, P = 0.007), 3.04 for moderate (95% CI: 1.76-5.24, P < 0.001), and 3.81 for severe (95% CI: 2.43-5.97, P < 0.001) LVH by indexed LV mass. The area under the receiver-operator characteristic (ROC) curve for the four degrees of LVH by indexed LV mass was superior [area under the curve (AUC) = 0.66] to that of the septal thickness partition values (AUC = 0.58, P = 0.0004). CONCLUSION In a large cohort study of unselected adult outpatients referred to the echocardiography laboratory, the measurements of indexed LV mass applying the ASE/EAE recommended cut-offs yielded remarkable discrepancy in the diagnosis of LVH severity and offered prognostic information beyond that provided by septal thickness only criteria.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Comparison of Cardiac Function in Young Patients with Thalassemia Intermedia and Healthy Individuals Using Echocardiography Method

Background: Cardiac dysfunction due to chronic anemia and hemosiderosis are the major causes of death among patients with thalassemia intermedia. This study was performed to compare the cardiac function in thalassemia intermedia patients with normal subjects by means of echocardiography. Materials and Methods: This was a case-control study performed on 22 patients affected by thalassemia int...

متن کامل

Normal left ventricular systolic time intervals assessed by pulsed wave Doppler echocardiography in the Turkmen horse of Iran

The Turkmen horse is one of the oldest and purest breeds in the world. There is no information with regards to the normal echocardiographic parameters of this horse regarding to cardiac diseases. Pulsed-wave (PW) Doppler echocardiography was performed on 42 clinically normal 3- to 15-year-old racing Turkmen horses. There were 26 stallions and 16 mares. The left ventricular isovolumetric contrac...

متن کامل

Comparison of Fetal Echocardiography for Fetal Cardiac Structure in Women with Gestational Diabetes Mellitus and Normal Pregnancies

BackgroundIncreased metabolic rate of hyperglycemia in gestational diabetes causes macrosomia, which can also affect the fetal heart. The thickness of the walls of the heart and its function in women with gestational diabetes mellitus (GDM) can change over time before treatment. We aimed to evaluate fetal cardiac structure in terms of ventricular wall thickness and its function in women w...

متن کامل

تعیین و مقایسه یافتههای اکوکاردیوگرافی بر اساس وضعیت Cardio Thoracic Ratio در گرافی قفسه سینه

Introduction: Chest X–Ray is one of the most common method of imaging. Cardio Thoracic Ratio ( CTR ) is one of the parameters of Chest X–Ray that is used for determining cardiac enlargement. Echocardiography as compared to Chest X–Ray is expensive and all centers dont have it, but it can determine heart size, valvular diseases, Ejection Fraction, Left Ventricular Hypertrophy (LVH), Pericardial...

متن کامل

Left ventricular hypertrophy in athletes.

Participation in regular intensive exercise is associated with a modest increase in left ventricular wall thickness (LVWT) and cavity size. The magnitude of these physiological changes is predominantly determined by a variety of demographic factors which include age, gender, size, ethnicity, and sporting discipline. A small minority of male athletes participating in sporting disciplines involvi...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • European heart journal cardiovascular Imaging

دوره 13 1  شماره 

صفحات  -

تاریخ انتشار 2012