Several studies addressed cardiovascular risk and mortality in the general population,
but data in veteran patients is lacking. This study was designed to investigate the
association between echocardiographic left ventricular hypertrophy (LVH) and all-cause
mortality in a male, high-risk group of veterans. Valid echocardiograms were evaluated
in 10,406 male veterans, mean age 68.3 ± 13 years. Using the left ventricular mass/body
surface area (LVM/BSA) method 6,575 (63.1%) patients had normal left LVMI and 3,831
(37.9%) had LVH, defined as LVMI ≥116 g/m2. Of those 1,371 (13.2%) had mild LVH, 1,025 (9.9%) moderate LVH, 605 (5.8%) severe,
and 830 (8%) had extreme LVH. After a mean follow up of 5.9 ± 4.4 years, a total of
3,550 (34.1%) patients died. Cox proportional hazard analyses adjusted for co-morbidities
revealed increased risk for individuals with mild LVH (hazard ratios [HR] 1.21; 95%
confidence intervals [CI]: 1.09 to 1.33); moderate LVH (HR 1.37; 95% CI: 1.23 to 1.52);
severe (HR = 1.36; 95% CI: 1.19 to 1.56); and extreme LVH, (HR = 1.95; 95% CI: 1.74
to 2.17). Similar findings were observed when LVMI was defined by LVM/m2.7. When LVM index was introduced as a continuous variable, mortality risk was 6.2%
higher per 10-unit change in LVMI, and 9.4% higher when defined by the m2.7 method. There was no difference in mortality risk between black and white patients,
or patients with concentric or eccentric LVH. We conclude that increased LVMI was
associated with increased risk of all-cause mortality. The incremental risk was significantly
higher in patients with extreme LVH.
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Article info
Publication history
Published online: January 07, 2020
Received in revised form:
December 5,
2019
Received:
October 2,
2019
Identification
Copyright
Published by Elsevier Inc.
