Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study

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• 作者：Paolo Verdecchia ; Giancarlo Carini ; Antonio Circo ; Emilio Dovellini ; Ezio Giovannini ; Michele Lombardo ; Pasquale Solinas ; Marco Gorini ; Aldo Pietro Maggioni
• 关键词：ACC/AHA Scientific Statements ; coronary disease ; electrocardiography ; exercise ; tests
• 刊名：Journal of the American College of Cardiology
• 出版年：2001
• 出版时间：December 2001
• 年：2001
• 卷：38
• 期：7
• 页码：1829-1835
• 全文大小：116 K

文摘

OBJECTIVES

This study investigated the prognostic value of left ventricular (LV) mass at echocardiography in uncomplicated subjects with essential hypertension.

BACKGROUND

Only a few single-center studies support the prognostic value of LV mass in uncomplicated hypertension.

METHODS

The MAssa Ventricolare sinistra nell’Ipertensione study was a multicenter (45 centers) prospective study. The prespecified aim was to explore the prognostic value of LV mass in hypertension. Admission criteria included essential hypertension, no previous cardiovascular events, and age ≥50. There was central reading of echocardiographic tracings. Treatment was tailored to the single subject.

RESULTS

Overall, 1,033 subjects (396 men) were followed for 0 to 4 years (median, 3 years). Mean age at entry was 60 years, and systolic/diastolic blood pressure was 154/92 mm Hg. The rate of cardiovascular events (×100 patient-years) was 1.3 in the group with normal LV mass and 3.2 in the group (28.5 % of total sample) with LV mass ≥125 g/body surface area (p = 0.005). After adjustment for age (p < 0.01), diabetes (p < 0.01), cigarette smoking (p < 0.01) and serum creatinine (p = 0.03), LV hypertrophy was associated with an increased risk of events (RR [relative risk] 2.08; 95 % CI [confidence interval]: 1.22 to 3.57). For each 39 g/m² (1 SD) increase in LV mass there was an independent 40 % rise in the risk of major cardiovascular events (95 % CI: 14 to 72; P = 0.0013).

CONCLUSIONS

Our findings show a strong, continuous and independent relationship of LV mass to subsequent cardiovascular morbidity. This is the first study to extend such demonstration to a large nationwide multicenter sample of uncomplicated subjects with essential hypertension.