Left ventricular mass and risk of cardiovascular events and all-cause death among ethnic Chinese--the Chin-Shan Community Cardiovascular Cohort study.
BACKGROUND
We conducted this cohort study involving ethnic Chinese population to explore the association between left ventricular mass and cardiovascular events and all-cause death, and to define the cutoff value of left ventricular mass for risk stratification.


METHODS
We evaluated 2604 participants aged ≥35years in the Chin-Shan Community Cardiovascular Cohort (CCCC) study who had received echocardiography without previous cardiovascular events. Left ventricular mass was divided by body surface area to obtain left ventricular mass index (LVMI). The end-points were all-cause death and incident cardiovascular events including coronary heart disease and stroke over a median follow-up of 14.4years.


RESULTS
By multivariate Cox regression analyses, a linear relationship between LVMI and cardiovascular events was found (adjusted hazard ratio 2.01, 95% CI, 1.11 to 3.63, for the highest quintile of LVMI compared with the lowest quintile, p for trend=0.001). A J-shape relationship between LVMI and all-cause death was observed, with the test for a linear relationship being rejected (p=0.003). The adjusted hazard ratios of all-cause death were significantly lower in the second quintile (0.58, 95% CI, 0.40 to 0.84) and in the third quintile (0.68, 95% CI, 0.47 to 0.96) of LVMI compared with the lowest quintile. The proposed cut-off value of LVMI was 105g/m(2) for prediction of cardiovascular events.


CONCLUSIONS
A linear relationship between LVMI and cardiovascular events, and a J-shape relationship between LVMI and all-cause death were found. The cut-off value derived from our Chinese population was lower than the frequently applied value derived from Caucasian population.
Lai
Chao-Lun
CL
Cardiovascular Center, Far Eastern Memorial Hospital, Taiwan.
Chien
Kuo-Liong
KL
Hsu
Hsiu-Ching
HC
Su
Ta-Chen
TC
Chen
Ming-Fong
MF
Lee
Yuan-Teh
YT
D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003327:Coronary Disease / Q000208:ethnology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000401:mortality*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology / Q000401:mortality; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography