Left ventricular mass estimation by different partition values in a large population of black hypertensive subjects.

Dike B Ojji,Ngabea Murtala,Anita Nnamonu,Ada Nwankwo,Bolaji Abdullahi,Sliwa Karen,Elena Libhaber,Jacob Alfa

doi:10.1002/hsr2.25

Abstract

AimsOur aim is to compare the impact of the 2 most widely used methods of indexing left ventricular mass (LVM) on the distribution of abnormal left ventricular (LV) geometric patterns, in a large sample of untreated asymptomatic black hypertensive subjects.Methods and ResultsAll patients with hypertension referred to the Cardiology unit of University of Abuja Teaching Hospital, Abuja, Nigeria from 2006 to 2013, who gave informed consent, and underwent physical examination and echocardiography. LVM indexation was classified into 4 geometric patterns after echocardiography: normal geometry, concentric hypertrophy, concentric remodeling, and eccentric hypertrophy. Concentric hypertrophy was the commonest geometric pattern and was detected in 33.6% to 39.5% of the patients. LVM/height2.7 was a better method to detect abnormal geometric pattern than LVM/BSA (P < 0.0001).ConclusionIn a large cohort of hypertensive subjects with no clinical evidence of cardiovascular disease, abnormal LV geometry was found in greater than four‐fifths of the population. In addition, LVM indexed for height 2.7 was found to be a better method for detecting LVH than LVM indexed for BSA, as the highest prevalence of abnormal geometry was diagnosed when LVM was indexed for height2.7.

Highlights

Left ventricular hypertrophy (LVH), as assessed by echocardiography, has been shown to be a strong and independent predictor of adverse prognosis in cardiovascular disease.[1-3]
left ventricular mass (LVM) indexed for height 2.7 was found to be a better method for detecting LVH than LVM indexed for BSA, as the highest prevalence of abnormal geometry was diagnosed when LVM was indexed for height2.7
By using LVM/HT2.7, we found that patients with eccentric hypertrophy had body mass index (BMI) that were significantly higher than those in patients with any of the other three geometric patterns

Summary

Introduction

Left ventricular hypertrophy (LVH), as assessed by echocardiography, has been shown to be a strong and independent predictor of adverse prognosis in cardiovascular disease.[1-3]. LVH is often further classified according to geometric pattern into 4 types: concentric hypertrophy, eccentric hypertrophy, concentric remodeling, and normal geometry.[4] This classification is important, as several studies have shown that subjects with concentric hypertrophy have the highest risk of cardiovascular events and deaths compared with those with concentric remodeling. The study by de Simone et al,[9] using the Dallas Heart Study classification, has further described the mechanism of geometric adaptation in hypertension, by showing that at any given normal ejection fraction, the balance between volume load co‐existing and pressure overload of hypertension influences the shape of LV geometric adaptation and the amount of left ventricular mass (LVM) and can impact prognosis. The prognostic impact of LV geometry does depend on LVM and on volume overload

Methods

Results

Conclusion