title: Left ventricular architecture and survival in African-Americans free of coronary heart disease (from the Atherosclerosis Risk in Communities [ARIC] study).
abstract: Published studies of the prognostic value of left ventricular (LV) hypertrophy and LV geometric pattern in African-Americans were based on referred or hospitalized patients with hypertension or coronary heart disease. All-cause mortality rates and survival associated with LV geometric pattern were determined using echocardiography in a population-based sample of middle-aged and elderly African-American men and women. During the third (1993 to 1995) visit of the ARIC Study, echocardiography was performed at the Jackson, Mississippi, field center on the cohort of 2,445 African-Americans aged 49 to 75 years. M-Mode LV echocardiographic measurements were available for 1,722 persons. Mortality data were available through December 31, 2003. During the follow-up period (median 8.8 years, maximum 10.4), 160 deaths were identified. In men, multivariable-adjusted hazard ratios for all-cause mortality (compared with men with normal LV geometry) were 1.75 (95% confidence interval [CI] 0.71 to 4.33) in those with concentric LV hypertrophy, 0.38 (95% CI 0.08 to 1.88) in those with eccentric LV hypertrophy, and 0.79 (95% CI 0.41 to 1.54) in those with concentric remodeling. In women, multivariable-adjusted hazard ratios for all-cause mortality (compared with women with normal LV geometry) were 1.17 (95% CI 0.48 to 2.84) in those with concentric LV hypertrophy, 1.23 (95% CI 0.46 to 3.28) in those with eccentric LV hypertrophy, and 1.17 (95% CI 0.60 to 2.28) in those with concentric remodeling. In conclusion, in this population-based cohort of middle-aged and elderly African-Americans free of coronary heart disease, adjustment for baseline differences in cardiovascular disease risk factors and LV mass greatly attenuated the strength of the association between LV pattern and all-cause mortality risk in women. In men, an association between concentric LV hypertrophy and mortality risk remained.
authors.affiliation: University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Herman A
authors.initials: HA
authors.lastname: Taylor
authors.forename: Alan D
authors.initials: AD
authors.lastname: Penman
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.forename: Abiola
authors.initials: A
authors.lastname: Dele-Michael
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Skelton
authors.forename: Ervin R
authors.initials: ER
authors.lastname: Fox
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002423:Cause of Death; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D011446:Prospective Studies; D012044:Regression Analysis; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D020257:Ventricular Remodeling