de Simone Giovanni, Gottdiener John S, Chinali Marcello, Maurer Mathew S
Department of Clinical and Experimental Medicine, Federico II University Hospital, via S.Pansini 5, 80131 Napoli, Italy.
Eur Heart J. 2008 Mar;29(6):741-7. doi: 10.1093/eurheartj/ehm605. Epub 2008 Jan 19.
The relationship of left ventricular hypertrophy (LVH) to incident heart failure (HF) not attributable to myocardial infarction (MI) has not been defined. We assessed whether LVH is an independent predictor of MI-independent HF.
LVH was assessed by echocardiographic LV mass index (in g/m2.7) and excess of LV mass (eLVM, in % of the observed value) relative to the amount predicted by sex, stroke work, and height, using a prognostically validated equation in 2078 participants of Cardiovascular Health Study without prevalent MI and normal systolic function. Increasing eLVM was associated with progressively increasing left atrial dimension and concentric geometry, decreasing systolic (P < 0.0001), and diastolic function (P < 0.04). After adjustment for age, sex, obesity, diabetes, hypertension, and antihypertensive therapy, and accounting for by incident MI, hazard of HF increased by 1% for each 1% increase in eLVM and by 3% for each g/m2.7 increase in LV mass index (both P < 0.0001). The results were confirmed when also C-reactive protein and measures of systolic (endocardial shortening) and diastolic function (categories of E/A ratio) were added to the Cox models.
In an elderly population, LVH, measured as LV mass index or eLVM is an independent predictor of incident HF not related to prevalent or incident MI.
左心室肥厚（LVH）与非心肌梗死（MI）所致的新发心力衰竭（HF）之间的关系尚未明确。我们评估了LVH是否是不依赖MI的HF的独立预测因素。
在心血管健康研究的2078名无既往MI且收缩功能正常的参与者中，使用经过预后验证的方程，通过超声心动图测量左心室质量指数（以g/m².⁷为单位）以及相对于根据性别、每搏功和身高预测的数值的左心室质量超标（eLVM，以观察值的百分比表示）来评估LVH。eLVM增加与左心房内径逐渐增大和向心性几何形态相关，收缩功能（P < 0.0001）和舒张功能（P < 0.04）降低。在调整年龄、性别、肥胖、糖尿病、高血压和抗高血压治疗，并考虑新发MI后，eLVM每增加1%，HF风险增加1%，左心室质量指数每增加1 g/m².⁷，HF风险增加3%（均P < 0.0001）。当将C反应蛋白以及收缩功能（心内膜缩短）和舒张功能（E/A比值类别）指标添加到Cox模型中时，结果得到证实。
在老年人群中，以左心室质量指数或eLVM衡量的LVH是与既往或新发MI无关的新发HF的独立预测因素。
