Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines

Zhou, Dan; Yan, Mengqi; Cai, Anping; Xie, Qibing; Cheng, Qi; Tang, Songtao; Feng, Yingqing

doi:10.1111/jch.14687

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…Hence, its detection stratifies the cardiovascular risk of patients with and without HHD and has considerable impact on patients' management and prognosis. Both LV thickening and increased LV mass rely on linear measurements of LV dimensions on 2-dimensional (2D) images, while LV mass calculation uses geometric assumptions regarding the LV shape [26]. The echocardiography image quality is of paramount importance for measurements.…”

Section: Left Ventricular Hypertrophymentioning

confidence: 99%

Challenges in Echocardiography for the Diagnosis and Prognosis of Non-Ischemic Hypertensive Heart Disease

Kadoglou,

Mouzarou,

Hadjigeorgiou

et al. 2024

JCM

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It has been well established that arterial hypertension is considered as a predominant risk factor for the development of cardiovascular diseases. Despite the link between arterial hypertension and cardiovascular diseases, arterial hypertension may directly affect cardiac function, leading to heart failure, mostly with preserved ejection fraction (HFpEF). There are echocardiographic findings indicating hypertensive heart disease (HHD), defined as altered cardiac morphology (left ventricular concentric hypertrophy, left atrium dilatation) and function (systolic or diastolic dysfunction) in patients with persistent arterial hypertension irrespective of the cardiac pathologies to which it contributes, such as coronary artery disease and kidney function impairment. In addition to the classical echocardiographic parameters, novel indices, like speckle tracking of the left ventricle and left atrium, 3D volume evaluation, and myocardial work in echocardiography, may provide more accurate and reproducible diagnostic and prognostic data in patients with arterial hypertension. However, their use is still underappreciated. Early detection of and prompt therapy for HHD will greatly improve the prognosis. Hence, in the present review, we shed light on the role of echocardiography in the contemporary diagnostic and prognostic approaches to HHD.

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Section: Left Ventricular Hypertrophymentioning

confidence: 99%

Challenges in Echocardiography for the Diagnosis and Prognosis of Non-Ischemic Hypertensive Heart Disease

Kadoglou,

Mouzarou,

Hadjigeorgiou

et al. 2024

JCM

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Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines

Zhou

Yan

Cai

et al. 2023

J of Clinical Hypertension

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To compare the predictive value of mortality between left ventricular hypertrophy (LVH) defined by Chinese thresholds and defined by international guidelines in hypertension individuals and investigate better indexation methods for LVH in Chinese population. We included 2454 community hypertensive patients with Left ventricular mass (LVM) and relative wall thickness. LVM was indexed to body surface area (BSA), height2 7 and height 1 7. The outcomes were all‐cause and cardiovascular mortality. Cox proportional hazards models were used to explore the association between LVH and the outcomes. C‐statistics and time‐dependent receiver operating characteristic curve (ROC) was used to evaluate the value of those indicators. During a median follow‐up of 49 months (interquartile range 2–54 months), 174 participants (7.1%) died from any cause (n = 174), with 71 died of cardiovascular disease. LVM/BSA defined by the Chinese thresholds was significantly associated with cardiovascular mortality (HR: 1.63; 95%CI: 1.00‐2.64). LVM/BSA was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.56; 95%CI: 1.14‐2.14) and using Guideline thresholds (HR: 1.52; 95%CI: 1.08‐2.15). LVM/Height1.7 was significantly associated with all‐cause mortality using Chinese thresholds (HR: 1.60; 95%CI: 1.17‐2.20) and using Guideline thresholds (HR: 1.54; 95%CI: 1.04‐2.27). LVM/Height2.7 was not significantly associated with all‐cause mortality. C‐statistics indicated that LVM/BSA and LVM/Height1.7 by Chinese thresholds had better predictive ability for mortality. Time‐ROC indicated that only LVM/Height1.7 defined by Chinese threshold had incremental value for predicting mortality. We found that in community hypertensive populations, race‐specific thresholds should be used to classify LV hypertrophy related to mortality risk stratification. LVM/BSA and LVM/Height1.7 are acceptable normalization method in Chinese hypertension.

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Influence of hypertension and global or abdominal obesity on left ventricular hypertrophy: A cross‐sectional study

Zhang,

Li,

Zhang

et al. 2023

J of Clinical Hypertension

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Although hypertension and obesity are both risk factors for left ventricular hypertrophy (LVH), the extent of their impact on LVH in the general population is still unclear, and the predictive value of obesity indicators for LVH remains to be elucidated. In this study, obesity‐related indicators, including waist circumference (WC), waist‐height ratio (WHTR), and waist‐hip ratio (WHR), were used to define abdominal obesity (AO), whereas body mass index (BMI) was used to measure general obesity (GO). The effects of hypertension and obesity on LVH were estimated using logistic regression analysis, as was the relative risk of LVH based on the presence of obesity, hypertension, or both. Subgroup analyses were performed based on sex and age. Of the 9134 participants (≥35 years old), 915 (10.0%) developed LVH. After adjusting for covariates, the odds ratios (95% confidence intervals) for LVH were 3.94 (3.27–4.75) in patients with hypertension, 1.90 (1.60–2.26) in those with GO, and 1.45 (1.25–1.69), 1.69 (1.43–2.00), and 1.54 (1.33–4.75) in individuals with AO defined based on WC, WHTR, and WHR, respectively. Analysis by sex showed similar values in women, but AO based on WC and WHR were not significantly associated with LVH in men. Further, after adjusting for potential confounding factors, concomitant hypertension and obesity had an increased risk of developing LVH in all age ranges, particularly in patients aged 35–45 years (risk increased 14.14‐fold, 10.84‐fold, 7.97‐fold, and 9.95‐fold for BMI‐based GO and WC‐, WHTR‐, and WHR‐based AO, respectively), and in both men and women but particularly in men (risk increased 7.71‐fold, 4.67‐fold, 5.83‐fold, and 5.58‐fold, respectively). In summary, all obesity indicators (BMI, WC, WHTR, and WHR) had predictive value for LVH in women; however, only BMI and WHTR should be considered for men. Furthermore, monitoring for the occurrence and progression of LVH is imperative for rural Chinese patients with concomitant hypertension and obesity, especially men and those aged 35–45 years.

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Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines

Cited by 4 publications

References 27 publications

Challenges in Echocardiography for the Diagnosis and Prognosis of Non-Ischemic Hypertensive Heart Disease

Challenges in Echocardiography for the Diagnosis and Prognosis of Non-Ischemic Hypertensive Heart Disease

Prognostic implications of left ventricular hypertrophy defined by the thresholds from the international and Chinese guidelines

Influence of hypertension and global or abdominal obesity on left ventricular hypertrophy: A cross‐sectional study

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