Association between left ventricular remodeling and coronary chronic total occlusion in hypertensive coronary artery disease patients

Figures

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  Fig. 1. Population Distribution and CTO Incidence Based on Left Ventricular Mass Index and Relative Wall Thickness in Hypertensive CAD Patients. The density plot depicts the distribution of the population based on left ventricular mass index (LVMI) and relative wall thickness (RWT), with density levels indicated by a color gradient from low (blue) to high (red). Left ventricular geometry is categorized into four patterns: normal, concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH), based on LVMI (95 g/m2 for females, 115 g/m2 for males) and RWT (0.42). The corresponding incidence of chronic total occlusion (CTO) for each pattern is indicated on the plot.

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  Fig. 2. Dose–Response Association of Left Ventricular Mass Index and Relative Wall Thickness with the Risk of CTO. Restricted cubic spline models demonstrate the dose–response association between left ventricular mass index (LVMI) (A) and relative wall thickness (RWT) (B) with the risk of chronic total occlusion (CTO). After excluding patients with LVMI or RWT values beyond the 1st and 99th percentiles, spline analyses were conducted with four knots placed at specific distribution percentiles (5%, 35%, 65%, and 95%). The spline model was adjusted for age, gender, BMI, smoking status, alcohol consumption, type 2 diabetes, controlled hypertension, LDL-C, acute coronary syndrome (ACS), and medications. Odds ratios (OR) for CTO are shown with 95% confidence intervals (CI). In panel (A), the risk of CTO increases with higher LVMI, particularly when LVMI exceeds approximately 100 g/m2. In panel (B), a decrease in RWT is associated with an increased risk of CTO, especially when RWT falls below approximately 0.4.

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  Fig. 3. Subgroup Analysis of Left Ventricular Remodeling and CTO in Hypertensive CAD Patients. Subgroup analysis of the association between left ventricular remodeling and CTO in hypertensive CAD patients. The odds ratios (OR) with 95% confidence intervals (CI) are presented for different subgroups, including age (< 65 vs. ≥ 65 years), gender (male vs. female), BMI (< 24 vs. ≥ 24 kg/m2), type 2 diabetes (no vs. yes), current hypertension status (controlled vs. uncontrolled), hypertension duration (< 5 vs. ≥ 5 years), LDL-C (< 1.8 vs. ≥ 1.8 mmol/L), and clinical presentation (ACS vs. non-ACS). The P values for interaction are provided to assess the heterogeneity of the associations across subgroups.