Patients (n = 536) with chronic HF, ejection fraction <50 % and LV end-diastolic volume index >91 mL/m2, classified according to LV mass index and relative wall thickness (RWT), were followed up for 33 ± 21 months. Ventricular mass was determined using a standard M-mode echocardiographic method. Relative wall thickness was defined as the ratio of (sum of interventricular septum thickness in diastole + posterior wall thickness in diastole)/LV end-diastolic diameter.
Prevalence of the pattern of increased LV mass index, defined as LV mass index >148 g/m2 in men and >122 g/m2 in women, and decreased RWT (<0.34) was 29 % . Multivariable predictors of all-cause mortality were age >70 years (P < .0001), New York Heart Association class >2 (P < .0001), increased LV mass index, and decreased RWT (P = .003), E wave deceleration time ≤140 ms (P = .005), and male gender (P = .025). Patients with increased LV mass index and decreased RWT had a worse survival (33 % ) than patients with less LV mass index and normal to reduced RWT (log-rank 23.92; P < .0001). Comparisons of Cox models showed that the combination of increased mass index and decreased RWT added prognostic value to a model that included ejection fraction and end-systolic volume index.
In patients with systolic HF, an independent and incremental risk of adverse outcome was associated with increased mass index and decreased RWT.