title: Prognostic impact of left ventricular mass severity according to the classification proposed by the American Society of Echocardiography/European Association of Echocardiography.
abstract: BACKGROUND
  The American Society of Echocardiography (ASE) and European Association of Echocardiography (EAE) recommend the use of quantitative estimation of left ventricular (LV) mass and defined partition values for mild, moderate, and severe hypertrophy. However, the prognostic implications associated with this categorization are unknown.
  
  
  METHODS
  In this observational cohort study of unselected adults undergoing echocardiography for any indication, LV hypertrophy was assessed using the ASE/EAE-recommended formula and measurement convention from LV linear dimensions indexed to body surface area. Mortality and incident hospitalizations for cardiovascular disease were the outcomes of this study.
  
  
  RESULTS
  Of 2,545 subjects (mean age, 61.9 ± 15.8 years; 56.3% women), 52.9% had normal LV mass, and 15.4% had mild, 12.1% moderate, and 19.6% severe LV hypertrophy. During a mean follow-up period of 2.5 ± 1.2 years, 121 deaths and 292 incident hospitalizations for cardiovascular disease occurred. In multivariate models including age, gender, LV ejection fraction, wall motion score index, significant valvular disease, and atrial fibrillation, the adjusted hazard ratios for death were 1.81 (95% confidence interval [CI], 1.03-3.20; P = .041) for mild, 2.31 (95% CI, 1.33-4.01; P = .003) for moderate, and 2.30 (95% CI, 1.39-3.79, P = .001) for severe LV hypertrophy. The adjusted hazard ratios for incident cardiovascular hospitalizations were 1.24 (95% CI, 0.84-1.82; P = .277) for mild, 2.02 (95% CI, 1.42-2.88; P = .0001) for moderate, and 2.38 (95% CI, 1.75-3.22, P < .0001) for severe LV hypertrophy. After adjustment for known risk predictors, there was a 1.3-fold risk for death and cardiovascular disease events per category of LV mass (P = .001).
  
  
  CONCLUSIONS
  In a cohort study of unselected adult outpatients, the categorization of LV mass according to the ASE/EAE recommendations offered prognostic information independently of age, gender, and other known predictors.
authors: Department of Cardiology, Policlinico Hospital, Modena and Reggio Emilia University, Modena, Italy.
authors: Andrea
authors: A
authors: Barbieri
authors: Francesca
authors: F
authors: Bursi
authors: Francesca
authors: F
authors: Mantovani
authors: Chiara
authors: C
authors: Valenti
authors: Michele
authors: M
authors: Quaglia
authors: Elena
authors: E
authors: Berti
authors: Massimiliano
authors: M
authors: Marino
authors: Maria Grazia
authors: MG
authors: Modena
mesh_terms: D017677:Age Distribution; D004452:Echocardiography / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000401:mortality*; D007558:Italy / Q000453:epidemiology; D008297:Male; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States