Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study.
OBJECTIVE
This study investigated the prognostic value of left ventricular (LV) mass at echocardiography in uncomplicated subjects with essential hypertension.


BACKGROUND
Only a few single-center studies support the prognostic value of LV mass in uncomplicated hypertension.


METHODS
The MAssa Ventricolare sinistra nell'Ipertensione study was a multicenter (45 centers) prospective study. The prespecified aim was to explore the prognostic value of LV mass in hypertension. Admission criteria included essential hypertension, no previous cardiovascular events, and age > or =50. There was central reading of echocardiographic tracings. Treatment was tailored to the single subject.


RESULTS
Overall, 1,033 subjects (396 men) were followed for 0 to 4 years (median, 3 years). Mean age at entry was 60 years, and systolic/diastolic blood pressure was 154/92 mm Hg. The rate of cardiovascular events (x100 patient-years) was 1.3 in the group with normal LV mass and 3.2 in the group (28.5% of total sample) with LV mass > or =125 g/body surface area (p = 0.005). After adjustment for age (p < 0.01), diabetes (p < 0.01), cigarette smoking (p < 0.01) and serum creatinine (p = 0.03), LV hypertrophy was associated with an increased risk of events (RR [relative risk] 2.08; 95% CI [confidence interval]: 1.22 to 3.57). For each 39 g/m(2) (1 SD) increase in LV mass there was an independent 40% rise in the risk of major cardiovascular events (95% CI: 14 to 72; p = 0.0013).


CONCLUSIONS
Our findings show a strong, continuous and independent relationship of LV mass to subsequent cardiovascular morbidity. This is the first study to extend such demonstration to a large nationwide multicenter sample of uncomplicated subjects with essential hypertension.
Verdecchia
P
P
ANMCO Research Center, Via La Marmora, 36, Firenze, Italy. verdec@tin.it
Carini
G
G
Circo
A
A
Dovellini
E
E
Giovannini
E
E
Lombardo
M
M
Solinas
P
P
Gorini
M
M
Maggioni
A P
AP
D000368:Aged; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D004453:Echoencephalography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000401:mortality; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors