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Impact of left ventricular geometry on long-term survival in elderly men and women
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
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2014 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 34, no 6, 442-448 p.Article in journal (Refereed) Published
Abstract [en]

Background: Adverse loading conditions and cardiac injury lead to remodelling of the heart into different patterns of left ventricular (LV) geometry. Geometry can be classified into LV hypertrophy (LVH), concentric remodelling (CR) or normal geometry (NG). The prognostic implications of the different geometric patterns have been extensively studied in middle-aged subjects, but data are scarcer for elderly populations. Methods: From a community-based random sample of 75-year-old men and women, subjects with normal LVEF were selected (n = 303). All-cause and cardiovascular mortality was analysed by LV geometry with Cox regression (unadjusted and adjusted for sex, prevalent hypertension, smoking, diabetes and prevalent ischaemic heart disease). Median follow-up time was 9.9 years. Results: Prevalence of CR and LVH was 19% and 17%, respectively. Hazard ratios (HRs) for CR were 0.93 (95% CI 0.54-1.58) for all-cause and 1.13 (0.48-2.65) for cardiovascular mortality. HRs for LVH were 2.01 (1.30-3.10) for all-cause and 3.55 (1.89-6.67) for cardiovascular mortality. As non-proportionality was present in the form of an increasing hazard for LVH, we partitioned the follow-up time at the median event time (approximately 7 years) and performed Cox regression separately within each time period. HRs for LVH during the first period were 1.23 (0.63-2.42) for all-cause and 1.79 (0.69-4.65) for cardiovascular mortality, while HRs for the second period were 3.06 (1.73-5.41) for all-cause and 6.60 (2.82-15.39) for cardiovascular mortality. Conclusion: In this community-based sample of 75-year-old men and women with normal LVEF, LVH was associated with an adverse prognosis during long-term follow-up, whereas CR was not.

Place, publisher, year, edition, pages
2014. Vol. 34, no 6, 442-448 p.
Keyword [en]
aged, left ventricular hypertrophy, mortality, ventricular remodelling
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-240232DOI: 10.1111/cpf.12114ISI: 000345639300004PubMedID: 24314203OAI: oai:DiVA.org:uu-240232DiVA: diva2:776278
Available from: 2015-01-07 Created: 2015-01-06 Last updated: 2015-01-07Bibliographically approved

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Nilsson, GöranHedberg, Pär
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Centre for Clinical Research, County of Västmanland
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