title: Prognostic value of the extent of left ventricular hypertrophy and its evolution in the hypertensive patient.
abstract: OBJECTIVE
  Left ventricular hypertrophy (LVH) is a marker of cardiovascular risk. However, the progression of the risk as a function of the course of the LVH has only been the subject of few studies.
  
  
  METHODS
  We report the consequences of the evolution of the left ventricular mass (LVM) in a cohort of hypertensive patients whose LVM was measured before any antihypertensive treatment.
  
  
  RESULTS
  We followed up for an average of 12 years, 763 hypertensives with LVM measurement by echocardiography on inclusion. In this population, 117 cardiovascular complications occurred and the initial LVM appeared to be the most powerful marker of risk. A cutoff of 51 g/m(2.7) for the LVM index (LVMI) offered the best compromise of sensitivity and specificity in the prediction of complications. A second determination of LVM was carried out in 436 patients on average 5 years after inclusion. In this sub-group, 82 complications were recorded after an average interval of 13 years. The 51 g/m(2.7) value of LVMI over the follow-up offered the same sensitivity (74%) and specificity (52%) in the prediction of complications. The progression of the LVM was related to the occurrence of complications independently of the basal value and other risk factors.
  
  
  CONCLUSIONS
  We confirm LVMI as a powerful risk factor in hypertension with a cutoff of 51 g/m(2.7), which offers the same sensitivity and specificity whether the LVM was determined before or during treatment. The progression of LVM, on average 5 years after the initial measurement had a prognostic value independent of the initial determination.
authors.affiliation: Cardiology-Hypertension Department, University Hospital of Bordeaux, Bordeaux, France. philippe.gosse@chu-bordeaux.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Gosse
authors.forename: Antoine
authors.initials: A
authors.lastname: Cremer
authors.forename: Marion
authors.initials: M
authors.lastname: Vircoulon
authors.forename: Paul
authors.initials: P
authors.lastname: Coulon
authors.forename: Emilie
authors.initials: E
authors.lastname: Jan
authors.forename: Georgios
authors.initials: G
authors.lastname: Papaioannou
authors.forename: Sunthareth
authors.initials: S
authors.lastname: Yeim
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index