PMID- 10758966
OWN - NLM
STAT- MEDLINE
DCOM- 20000420
LR  - 20220316
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 35
IP  - 5
DP  - 2000 Apr
TI  - Echocardiographic predictors of clinical outcome in patients with left 
      ventricular dysfunction enrolled in the SOLVD registry and trials: significance 
      of left ventricular hypertrophy. Studies of Left Ventricular Dysfunction.
PG  - 1237-44
AB  - OBJECTIVES: To assess the relation of left ventricular (LV) and left atrial (LA) 
      dimensions, ejection fraction (EF) and LV mass to subsequent clinical outcome of 
      patients with LV dysfunction enrolled in the Studies of Left Ventricular 
      Dysfunction (SOLVD) Registry and Trials. BACKGROUND: Data are lacking on the 
      relation of LV mass to prognosis in patients with LV dysfunction and on the 
      interaction of LV mass with other measurements of LV size and function as they 
      relate to clinical outcome. METHODS: A cohort of 1,172 patients enrolled in the 
      SOLVD Trials (n = 577) and Registry (n = 595) had baseline echocardiographic 
      measurements and follow-up for 1 year. RESULTS: After adjusting for age, New York 
      Heart Association (NYHA) functional class, Trial vs. Registry and ischemic 
      etiology, a 1-SD difference in EF was inversely associated with an increased risk 
      of death (risk ratio, 1.62; p = 0.0008) and cardiovascular (CV) hospitalization 
      (risk ratio, 1.59; p = 0.0001). Consequently, the other echo parameters were 
      adjusted for EF in addition to age, NYHA functional class, Trial vs. Registry and 
      ischemic etiology. A 1-SD difference in LV mass was associated with increased 
      risk of death (risk ratio of 1.3, p = 0.012) and CV hospitalization (risk ratio 
      of 1.17, p = 0.018). Similar results were observed with the LA dimension 
      (mortality risk ratio, 1.32; p < 0.02; CV hospitalizations risk ratio, 1.18; p < 
      0.04). Likewise, LV mass > or =298 g and LA dimension > or =4.17 cm were 
      associated with increased risk of death and CV hospitalization. An end-systolic 
      dimension >5.0 cm was associated with increased mortality only. A protective 
      effect of EF was noted in patients with LV mass > or =298 g (those in the group 
      with EF >35% had lower mortality) but not in the group with LV mass <298 g. 
      CONCLUSIONS: In patients with LV dysfunction enrolled in the SOLVD Registry and 
      Trials, increasing levels of hypertrophy are associated with adverse events. A 
      protective effect of EF was noted in patients with LV mass > or =298 g (those in 
      the group with EF >35% fared better) but not in the group with LV mass <298 g. 
      These data support the development and use of drugs that can inhibit hypertrophy 
      or alter its characteristics.
FAU - Quinones, M A
AU  - Quinones MA
AD  - Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA. 
      guelq@bcm.tmc.edu
FAU - Greenberg, B H
AU  - Greenberg BH
FAU - Kopelen, H A
AU  - Kopelen HA
FAU - Koilpillai, C
AU  - Koilpillai C
FAU - Limacher, M C
AU  - Limacher MC
FAU - Shindler, D M
AU  - Shindler DM
FAU - Shelton, B J
AU  - Shelton BJ
FAU - Weiner, D H
AU  - Weiner DH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Aged
MH  - Cause of Death
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertrophy, Left Ventricular/*etiology
MH  - Male
MH  - Middle Aged
MH  - Patient Admission/statistics & numerical data
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Registries
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Ventricular Dysfunction, Left/complications/*diagnostic imaging/*mortality
EDAT- 2000/04/12 09:00
MHDA- 2000/04/25 09:00
CRDT- 2000/04/12 09:00
PHST- 2000/04/12 09:00 [pubmed]
PHST- 2000/04/25 09:00 [medline]
PHST- 2000/04/12 09:00 [entrez]
AID - S0735109700005118 [pii]
AID - 10.1016/s0735-1097(00)00511-8 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2000 Apr;35(5):1237-44. doi: 10.1016/s0735-1097(00)00511-8.