Increasing Left Ventricular Mass and Death in Men and Women Investigated With Echocardiography

作者：David Playford, Geoff Strange, Majo Joseph, Rebecca Perry, Yih‐Kai Chan, Jordan B. Strom, Nicholas Spetko, Sarah Ann Harris, Simon Stewart, Joseph B. Selvanayagam · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.125.041927 · 被引用次数：1 · 研究领域：Pulmonary Hypertension Research and Treatments、Cardiovascular Function and Risk Factors、Acute Myocardial Infarction Research

Background Left ventricular hypertrophy (LVH) categories are based on left ventricular mass index (LVMi). This study aimed to generate and externally validate sex‐stratified LVMi cutoffs according to incremental mortality risk. Methods LVH information was determined on 155 668 men (aged 61.3±17.3 years) and 147 880 women (61.8±18.3 years) from the National Echocardiography Database of Australia. Sex‐specific mild to severe thresholds of the increasing 5‐year mortality rate based on LVMi increments were generated. These new thresholds were then validated in a US Medicare‐linked echocardiographic database. Results In the National Echocardiography Database, 36198 men (23.3%) and 38 898 women (26.3%) had LVH, with an actual 5‐year mortality rate of 38.3% and 31.2%, respectively. The statistical threshold at which LVMi was associated with an increased mortality rate was lower than traditional criteria in both men (≥88 g/m 2 versus ≥115 g/m 2 ) and women (≥82 g/m 2 versus ≥95 g/m 2 ). In men, compared with the lowest‐risk LVMi stratum, the fully adjusted risk of 5‐year death was 14% (95% CI, 3%–25%) and 68% higher (95% CI, 49%–90%) when LVMi levels were mildly (88 to <116 g/m 2 ) to severely (≥140 g/m 2 ) increased, respectively. In women, the equivalent LVMi thresholds of 82 to <112 g/m 2 and ≥140 g/m 2 were associated with a 13% (95% CI, 3%–24%), and 81% higher (95% CI, 58%–208%) risk. The association of these LVMi thresholds and mortality risk was confirmed in the US valid...