Concentric hypertrophy was associated with increased all-cause mortality in women (HR 3.48, P<0.001) and men (HR 2.57, P<0.001), while eccentric hypertrophy was associated with mortality only in women.
Cohort (n=3,754)
Does the pattern of left ventricular hypertrophy (concentric vs. eccentric) differentially affect all-cause mortality in men versus women undergoing CMR and coronary angiography?
Left ventricular remodelling patterns differ by sex, with concentric hypertrophy predicting mortality in both sexes, whereas eccentric hypertrophy predicts mortality only in women.
Hazard Ratio: 3.48
p-value: p=<0.001
AIMS: Left ventricular hypertrophy (LVH) is the most common form of myocardial remodelling and predicts adverse outcomes in patients with coronary artery disease (CAD). However, sex-specific prevalence and prognostic significance of LVH patterns are poorly understood. We investigated the sex-specific influence of LVH pattern on clinical outcomes in patients undergoing cardiovascular magnetic resonance (CMR) and coronary angiography following adjustment for co-morbidities including CAD burden. METHODS AND RESULTS: Patients undergoing CMR and coronary angiography between 2005 and 2013 were included. Volumetric measurements of left ventricular (LV) mass with classification of concentric vs. eccentric remodelling patterns were determined from CMR cine images. Multivariable Cox analysis was performed to assess independent associations with the primary outcome of all-cause mortality. In total, 3754 patients were studied (mean age 59.3 ± 13.1 years), including 1039 (27.7%) women. Women were more likely to have concentric remodelling (8.1% vs. 2.1%, P < 0.001), less likely to have eccentric hypertrophy (15.1% vs. 26.8%, P < 0.001) and had a similar prevalence of concentric hypertrophy (6.1 vs. 5.2%, P = 0.296) compared to men. At a median follow-up of 3.7 years, 315 (8.4%) patients died. Following adjustment including CAD burden, concentric hypertrophy was associated with increased all-cause mortality in women adjusted hazard ratio (HR) 3.48, P < 0.001 and men (adjusted HR 2.57, P < 0.001). Eccentric hypertrophy was associated with all-cause mortality only in women (adjusted HR 1.78, P = 0.047). CONCLUSION: Patterns of LV remodelling differ by sex and LVH and provides prognostic information in both men and women. Our findings support the presence of sex-specific factors influencing LV remodelling.
Miller et al. (Thu,) conducted a cohort in Coronary artery disease (n=3,754). Left ventricular hypertrophy (LVH) patterns (concentric vs. eccentric) vs. Reference group (normal geometry/other patterns) was evaluated on All-cause mortality (HR 3.48, p=<0.001). Concentric hypertrophy was associated with increased all-cause mortality in women (HR 3.48, P<0.001) and men (HR 2.57, P<0.001), while eccentric hypertrophy was associated with mortality only in women.