THE PROGNOSTIC ROLE OF LEFT-VENTRICULAR HYPERTROPHY IN PATIENTS WITH OR WITHOUT CORONARY-ARTERY DISEASE

Objective: To examine the association between echocardiographically determined left ventricular hypertrophy and mortality in patients with and without coronary artery disease. Design: Cohort study with a mean follow-up period of 4 years. Setting: An inner-city public hospital in Chicago. Patients: A cohort of 785 patients, most of whom were black and had hypertension. Interventions: Coronary arteriography for presumed coronary artery disease and echocardiography. Main Outcome Measure: All-cause and cardiac mortality. Results: Left ventricular hypertrophy, based on left ventricular mass corrected for body surface area, was present in 194 of 381 patients (51%) with coronary artery disease and in 162 of 404 patients (40%) without coronary artery disease. Patients with left ventricular hypertrophy had worse survival than those without hypertrophy in both the group with coronary artery disease and the group without coronary artery disease. After adjustment was made for age at baseline, sex, and hypertension, the relative risk for death from any cause in patients with hypertrophy compared with patients without hypertrophy was 2.14 (95% Cl, 1.24 to 3.68) among those with coronary artery disease and 4.14 (Cl, 1.77 to 9.71) among those without coronary artery disease. Conclusions: Echocardiographically determined left ventricular hypertrophy is an important prognostic marker in patients with or without coronary artery disease. The effect of reversing ventricular hypertrophy in patients with and without coronary disease deserves further study.