Key result
High relative wall thickness links to ~64% higher long-term all-cause mortality.
Why the study?
Does high relative wall thickness (RWT > 0.42) increase long-term mortality in hospital-based patients without prior MI or significant valvular disease?
Cohort (n=3,654)
No
Does high relative wall thickness (RWT > 0.42) increase long-term mortality in hospital-based patients without prior MI or significant valvular disease?
Effect estimate: HR 1.64 (95% CI 1.27-2.10)
Absolute Event Rate: 18.3% vs 10.8%
p-value: p=<0.001
High relative wall thickness (>0.42) on echocardiography is an independent predictor of long-term all-cause mortality in a general hospital-based population.
May aid risk stratification in similar cohorts; leaves open whether RWT modification improves survival.
BACKGROUND: The prognostic impact of relative wall thickness (RWT), ventricular concentricity, is controversial. METHODS: We retrospectively analyzed data obtained from 4444 consecutive patients who had undergone both transthoracic echocardiography and electrocardiography at our hospital in 2013. Those who presented with a history of previous episodes of myocardial infarctions and severe or moderate valvular disease were excluded from the analysis. We calculated RWT as follows: (2 x diastolic posterior wall thickness) / (the diastolic LV dimension). We defined high RWT as a ratio > 0.42. A total of 3654 patients were categorized into two groups: 492 with high RWT, and 3162 with normal RWT. RESULTS: The mean ages of those in the normal and high RWT groups were 64.6 (±standard deviation 16.3) and 71.6 (± 12.7) years, respectively (p<0.001). Prevalence of male sex, history of diabetes, hypertension, and chronic kidney disease, and the left atrium volume index was higher for the high RWT group than for the normal RWT group. The median follow-up period was 1274 days (interquartile range, 410-1470). The Kaplan-Meier curves showed a constant increase in all-cause death, with cumulative 3-year incidences of 18.3% and 10.8% for the high RWT and normal RWT groups, respectively (log-rank p<0.001). After adjusting for confounders, the increased mortality risk for those with high RWT relative to normal RWT was significant (hazard ratio, 1.64; 95% confidence interval, 1.27-2.10). This trend was consistent for the composite of deaths and major adverse cardiac events. CONCLUSION: High RWT has a deleterious impact on long-term mortality.
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Seko et al. (2018) conducted a cohort in Patients undergoing echocardiography and electrocardiography (n=3,654). High relative wall thickness (>0.42) vs. Normal relative wall thickness was evaluated on All-cause death (HR 1.64, 95% CI 1.27-2.10, p=<0.001). High relative wall thickness (>0.42) was associated with a significantly increased risk of long-term all-cause mortality compared to normal relative wall thickness (HR 1.64; 95% CI 1.27-2.10).
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