August 21, 2026Journal of the American College of Cardiology345 citations
Ver artículo completoIncreased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years
Resultado clave
Increased baseline left ventricular mass was associated with developing a depressed left ventricular ejection fraction over 4.9 years (14.1% in highest vs 4.8% in lowest quartile; p<0.001).
Puntos clave
- To determine whether increased baseline left ventricular mass is an independent risk factor for the development of depressed left ventricular ejection fraction over five years.
- Analyzed 3,042 participants from the prospective longitudinal Cardiovascular Health Study with normal baseline LVEF and documented baseline LVM.
- Assessed LVM at enrollment using echocardiography and electrocardiography, followed by repeat echocardiograms at 4.9 ± 0.14 years to identify depressed LVEF (<55%).
- Calculated incident depressed LVEF rates across LVM quartiles and performed multivariable regression adjusting for confounders.
- Incident depressed LVEF developed in 4.8% of quartile 1, 4.4% of quartile 2, 7.5% of quartile 3, and 14.1% of quartile 4 baseline LVM indexed to body surface area (p < 0.001).
- Baseline echocardiographic LVM (p < 0.001) and electrocardiographic LVM (p < 0.001) independently predicted depressed LVEF in multivariable regression, with a persistent association in participants without myocardial infarction (p < 0.001).
Diseño del estudio
Tipo
Cohort (n=3,042)
PICO estructurado
Does increased left ventricular mass predict the development of a depressed left ventricular ejection fraction in patients with normal baseline LVEF?
P
Población
3,042 participants with normal baseline LVEF and assessed LVM, followed for approximately 4.9 years to evaluate the development of depressed LVEF.
E
Exposición
Increased baseline left ventricular mass (LVM) assessed by electrocardiogram or echocardiogram
C
Comparador
Lower baseline left ventricular mass (LVM)
O
Resultado
Development of a qualitatively depressed LVEF on two-dimensional echocardiography (corresponding approximately to an LVEF <55%) at follow-upsurrogate
Increased left ventricular mass is an independent risk factor for the development of depressed left ventricular ejection fraction within 5 years.
Resultado numérico
Tasa de eventos absoluta: 14.1% vs 4.8%
valor p: p=< 0.001
Resumen
OBJECTIVES: Our aim in this study was to determine whether increased left ventricular mass (LVM) is a risk factor for the development of a reduced left ventricular ejection fraction (LVEF). BACKGROUND: Prior studies have shown that increased LVM is a risk factor for heart failure but not whether it is a risk factor for a low LVEF. METHODS: As part of the Cardiovascular Health Study, a prospective population-based longitudinal study, we performed echocardiograms upon participant enrollment and again at follow-up of 4.9 +/- 0.14 years. In the present analysis, we identified 3,042 participants who had at baseline a normal LVEF and an assessment of LVM (either by electrocardiogram or echocardiogram), and at follow-up a measurable LVEF. The frequency of the development of a qualitatively depressed LVEF on two-dimensional echocardiography, corresponding approximately to an LVEF <55%, was analyzed by quartiles of baseline LVM. Multivariable regression determined whether LVM was independently associated with the development of depressed LVEF. RESULTS: Baseline quartile of echocardiographic LVM indexed to body surface area was associated with development of a depressed LVEF (4.8% in quartile 1, 4.4% in quartile 2, 7.5% in quartile 3, and 14.1% in quartile 4 p < 0.001). A similar relationship was seen in the subgroup of participants without myocardial infarction (p < 0.001). In multivariable regression that adjusted for confounders, both baseline echocardiographic (p < 0.001) and electrocardiographic (p < 0.001) LVM remained associated with development of depressed LVEF. CONCLUSIONS: Increased LVM as assessed by electrocardiography or echocardiography is an independent risk factor for the development of depressed LVEF.