Echocardiographic left ventricular geometry profiles for prediction of stroke, coronary heart disease and all-cause mortality in the Chinese community: a rural cohort population study

Abstract

Background The utility of echocardiographic left ventricular (LV) geometry in the prediction of stroke/coronary heart disease (CHD) and all-cause mortality is not well characterized. This study aimed to evaluate the overall and sex-specific prognostic value of different geometric patterns on the incidence of stroke/CHD and all-cause mortality in a Chinese population-based cohort. Methods We conducted a prospective study in the general population in Northeast China, and a total of 9940 participants aged ≥ 35 years underwent echocardiography for LV geometry and were successfully followed up for incident stroke/CHD and all-cause death. Cox proportional hazards models were utilized to estimate the association of baseline LV geometry with adverse outcomes. Results Over a median follow-up of 4.66 years, abnormal LV geometric patterns had increased crude incident rates of stroke/CHD and all-cause mortality compared with normal geometry in overall population and each sex group (all P < 0.05). Multivariable Cox analysis reported that LV concentric and eccentric hypertrophy were associated with incident stroke/CHD (concentric hypertrophy: hazard ratio (HR) = 1.39, 95% confidence interval (CI) = 1.04–1.86; eccentric hypertrophy: HR = 1.42, 95% CI = 1.11–1.82) and all-cause mortality (concentric hypertrophy: HR = 1.50, 95% CI = 1.07–2.12; eccentric hypertrophy: HR = 1.58, 95% CI = 1.19–2.10), and LV concentric remodeling was related to stroke/CHD incidence (HR = 1.42, 95% CI = 1.09–1.84) in total population compared to normal geometry after the adjustment for potential confounders. In men, a significant increase was observed from LV eccentric hypertrophy for incident stroke/CHD, whereas in women, LV concentric hypertrophy was associated with elevated incidence of both stroke/CHD and all-cause death, and eccentric hypertrophy was correlated with increased all-cause mortality (all P < 0.05). Conclusions Our prospective cohort supports that abnormal LV geometry by echocardiography has a prognostic significance for incident stroke/CHD and all-cause mortality, implying that early detection and intervention of LV structural remodeling in rural China are urgently needed to prevent adverse outcomes.

New-onset aortic dilatation in the population: a quarter-century follow-up

“…End-diastolic (d) and end-systolic (s) LV internal diameters (LVID), interventricular septum (IVS) thickness and posterior wall (PW) thickness were measured off-line from two-dimensionally guided M-mode tracings recorded at 50-100 cm/s speed, during at least three consecutive cycles. LV mass was estimated using the corrected ASE method: 0.8x(1.04x[(IVSd + LVIDd + PWTd) 3 -LVIDd 3 ]) + 0.6 and normalized to body surface area. (BSA).…”

“…Marfan's and Ehlers-Danlos syndromes) or atherosclerotic diseases [1]. Unlike most echocardiographic measures of cardiac structure [2][3][4][5], however, the value of aortic diameter for the stratification of cardiovascular risk in populations free from overt aortic disease is still poorly defined due to the fact that the association of aortic diameter with cardiovascular events and death relies on few longitudinal studies carried out in heterogeneous populations, based on different definitions of the aortic phenotypes and characterized by relatively short follow-ups [6][7][8][9][10]. These are the main reasons why the 2018 European Society of Cardiology/ European Society of Hypertension (ESC/ESH) guidelines did not include aortic diameter among the markers of cardiac damage to be considered in hypertensive patients [5].…”

“…These are the main reasons why the 2018 European Society of Cardiology/ European Society of Hypertension (ESC/ESH) guidelines did not include aortic diameter among the markers of cardiac damage to be considered in hypertensive patients [5]. Furthermore, although it is well known that ascending, thoracic and abdominal aortic diameters increase with aging [11,12], a limited knowledge exists on the prevalence, correlates and time-related changes of aortic dilatation [3][4][5][6][7][8][9][10][11][12][13][14][15]. In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, echocardiographic and clinical data (including office ambulatory and home blood pressure, BP) have been collected at the start and after 10 and 25 years in an Italian population sample with an average initial age of 42 years.…”

Utilidad diagnóstica del ECG para predecir la geometría del ventrículo izquierdo por ecocardiograma

“…In prospective studies, the left ventricular geometry has been identified as an adverse cardiovascular prognostic factor 1 , 2 . There are four distinct left ventricular geometries according to the American Society of Echocardiography: normal (NL), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) 3 .…”

Predictors of Cardiovascular Complications in Men With Stable Coronary Heart Disease and Arterial Hypertension

“…Ухудшение прогноза и повышение риска сердечно-сосудистых осложнений (ССО) у больных ИБС с сопутствующей АГ в существенной степени связаны с изменением геометрии, структуры и массы левого желудочка (ЛЖ), а также с возрастом, полом и сопутствующими заболеваниями [5,6]. Очевидно, что вопрос анализа предикторов ССО у больных ИБС и АГ представляется весьма актуальным и нуждается в более детальном обсуждении [2,4,7,8].…”