Left ventricular (LV) mass and geometry are associated with risk of cardiovascular
disease (CVD). We sought to determine whether LV mass and geometry contribute to risk
prediction for CVD in adults aged ≥65 years of the Cardiovascular Health Study. We
indexed LV mass to body size, denoted as LV mass index (echo-LVMI), and we defined
LV geometry as normal, concentric remodeling, and eccentric or concentric LV hypertrophy.
We added echo-LVMI and LV geometry to separate 10-year risk prediction models containing
traditional risk factors and determined the net reclassification improvement (NRI)
for incident coronary heart disease (CHD), CVD (CHD, heart failure [HF], and stroke),
and HF alone. Over 10 years of follow-up in 2,577 participants (64% women, 15% black,
mean age 72 years) for CHD and CVD, the adjusted hazards ratios for a 1-SD higher
echo-LVMI were 1.25 (95% CI 1.14 to 1.37), 1.24 (1.15 to 1.33), and 1.51 (1.40 to
1.62), respectively. Addition of echo-LVMI to the standard model for CHD resulted
in an event NRI of −0.011 (95% CI −0.037 to 0.028) and nonevent NRI of 0.034 (95%
CI 0.008 to 0.076). Addition of echo-LVMI and LV geometry to the standard model for
CVD resulted in an event NRI of 0.013 (95% CI −0.0335 to 0.0311) and a nonevent NRI
of 0.043 (95% CI 0.011 to 0.09). The nonevent NRI was also significant with addition
of echo-LVMI for HF risk prediction (0.10, 95% CI 0.057 to 0.16). In conclusion, in
adults aged ≥65 years, echo-LVMI improved risk prediction for CHD, CVD, and HF, driven
primarily by improved reclassification of nonevents.
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Article info
Publication history
Published online: June 13, 2016
Accepted:
June 3,
2016
Received in revised form:
June 3,
2016
Received:
January 13,
2016
Footnotes
This research was supported by contracts HHSN268201200036 C, HHSN268200800007 C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grant HL080295 from the National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland, with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, Maryland. Additional support was provided by AG023629 from the National Institute on Aging (NIA), Bethesda, Maryland. A full list of principal CHS investigators and institutions can be found at http://www.chs-nhlbi.org/PI.htm. Dr. Desai was supported by grant T32 HL-69771-8 from the National Institutes of Health, Bethesda, Maryland.
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