title: Relationship between arterial impedance and concentric remodeling in patients with normal systolic function: impact on prevalence and survival.
abstract: Although concentric remodeling (CR) is associated with increased morbidity and mortality, little is known regarding the interaction of arterial impedance (IMP) on survival in CR. The authors evaluated 50,421 patients with normal systolic function to assess prevalence of CR and impact of CR and IMP on survival (mean follow-up, 3.9±2.3 years.) In 2636 patients with paired echocardiograms, the authors assessed the impact of IMP on mortality, based on maintaining a high or low IMP (> or <4.0 mm Hg/mL/m(2) ). CR occurred in 21% of patients and was associated with twice the mortality compared with patients with normal left ventricular (LV) structure (P<.0001). The prevalence of CR increased with increasing IMP (P<.001 for trend). In the paired cohort, CR patients with an IMP <4.0 had a mortality of 6.3%, with 58% converting to normal LV structure, whereas mortality was higher (10%; P<.0001) and conversion to normal LV structure was less frequent (46%; P<.001) in those whose IMP remained ≥4.0. CR is prevalent and associated with high mortality and increases with higher IMP. Reducing IMP levels in CR is associated with lower mortality and greater conversion to normal LV structure. Studies are needed to determine whether reporting and targeting IMP is beneficial in CR.
authors: Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana 707121, USA. clavie@ochsner.org
authors: Carl J
authors: CJ
authors: Lavie
authors: Elise L
authors: EL
authors: Milani
authors: Hector O
authors: HO
authors: Ventura
mesh_terms: D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D055820:New Orleans / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013599:Systole; D014655:Vascular Resistance / Q000502:physiology*; D016276:Ventricular Function / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*