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Left ventricular global wall thickness is easily calculated, detects and characterizes hypertrophy, and has prognostic utility

Lundin, Magnus; Heiberg, Einar LU ; Nordlund, David LU ; Gyllenhammar, Tom LU ; Steding Ehrenborg, Katarina LU ; Engblom, Henrik LU ; Carlsson, Marcus LU ; Atar, Dan; vanderPals, Jesper LU and Erlinge, David LU , et al. (2019) 20th Cardiovascular Spring Meeting
Abstract
BACKGROUND: Cardiovascular magnetic resonance (CMR) can be used to measure left ventricular end-diastolic volume (LVEDV) and left ventricular mass (LVM). However, there is currently no good way to measure the normality of LVM in relation to a given LVEDV. We hypothesized that a simple measure of left ventricular global wall thickness (GWT) would be accurate, beneficial for detecting and characterizing hypertrophy, and have prognostic significance.
METHODS: Subjects underwent CMR at 1.5T, including healthy volunteers (n=99) and patients assessed for heart disease (n=2828).
RESULTS: GWT calculated from LVEDV and LVM had excellent agreement with measured mean end-diastolic wall thickness of the entire left ventricle (bias... (More)
BACKGROUND: Cardiovascular magnetic resonance (CMR) can be used to measure left ventricular end-diastolic volume (LVEDV) and left ventricular mass (LVM). However, there is currently no good way to measure the normality of LVM in relation to a given LVEDV. We hypothesized that a simple measure of left ventricular global wall thickness (GWT) would be accurate, beneficial for detecting and characterizing hypertrophy, and have prognostic significance.
METHODS: Subjects underwent CMR at 1.5T, including healthy volunteers (n=99) and patients assessed for heart disease (n=2828).
RESULTS: GWT calculated from LVEDV and LVM had excellent agreement with measured mean end-diastolic wall thickness of the entire left ventricle (bias 0.01±0.23mm). GWT was most predictive of death or hospitalization for heart failure in patients with normal findings by CMR (n=326, log-rank 26.8, p<0.001, median [interquartile range] follow-up 5.8 [5.0–6.7] years). GWT indexed to body surface area (GWTi) was most predictive of outcomes in patients with normal LVEDV index (n=1352, log-rank 36.4, p<0.001, follow-up 5.5 [4.1–6.5] years). Patients with concentric remodeling had worse prognosis than the normal patients (p=0.02), and the patients with hypertrophy had worse prognosis than both normal patients (p<0.001) and patients with concentric remodeling (p=0.045), see Figure 1. Of patients with suspected heart disease but normal CMR findings regarding left ventricular volumes, function, mass, and scar, 22% were found to have increased mean GWTi corresponding to concentric remodeling, see Figure 2.
CONCLUSIONS: Left ventricular GWT is an intuitive measure that can be easily calculated from mass and volume with high accuracy, and has prognostic utility in patients with normal CMR findings. Also, GWTi classifies hypertrophy as concentric or eccentric, and detects concentric remodeling in a substantial portion of patients with otherwise normal findings. (Less)
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Contribution to conference
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keywords
MRI, Magnetic Resonance Imaging, Hyperthrophy
conference name
20th Cardiovascular Spring Meeting
conference location
Gothenburg, Sweden
conference dates
2019-04-10 - 2019-04-12
language
English
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yes
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3deeb159-dba0-4e00-be60-aa2dac95a1cf
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2019-05-28 22:36:49
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2019-06-12 02:18:00
@misc{3deeb159-dba0-4e00-be60-aa2dac95a1cf,
  abstract     = {BACKGROUND: Cardiovascular magnetic resonance (CMR) can be used to measure left ventricular end-diastolic volume (LVEDV) and left ventricular mass (LVM). However, there is currently no good way to measure the normality of LVM in relation to a given LVEDV. We hypothesized that a simple measure of left ventricular global wall thickness (GWT) would be accurate, beneficial for detecting and characterizing hypertrophy, and have prognostic significance.<br/>METHODS: Subjects underwent CMR at 1.5T, including healthy volunteers (n=99) and patients assessed for heart disease (n=2828).<br/>RESULTS: GWT calculated from LVEDV and LVM had excellent agreement with measured mean end-diastolic wall thickness of the entire left ventricle (bias 0.01±0.23mm). GWT was most predictive of death or hospitalization for heart failure in patients with normal findings by CMR (n=326, log-rank 26.8, p&lt;0.001, median [interquartile range] follow-up 5.8 [5.0–6.7] years). GWT indexed to body surface area (GWTi) was most predictive of outcomes in patients with normal LVEDV index (n=1352, log-rank 36.4, p&lt;0.001, follow-up 5.5 [4.1–6.5] years). Patients with concentric remodeling had worse prognosis than the normal patients (p=0.02), and the patients with hypertrophy had worse prognosis than both normal patients (p&lt;0.001) and patients with concentric remodeling (p=0.045), see Figure 1. Of patients with suspected heart disease but normal CMR findings regarding left ventricular volumes, function, mass, and scar, 22% were found to have increased mean GWTi corresponding to concentric remodeling, see Figure 2.<br/>CONCLUSIONS: Left ventricular GWT is an intuitive measure that can be easily calculated from mass and volume with high accuracy, and has prognostic utility in patients with normal CMR findings. Also, GWTi classifies hypertrophy as concentric or eccentric, and detects concentric remodeling in a substantial portion of patients with otherwise normal findings.},
  author       = {Lundin, Magnus and Heiberg, Einar and Nordlund, David and Gyllenhammar, Tom and Steding Ehrenborg, Katarina and Engblom, Henrik and Carlsson, Marcus and Atar, Dan and vanderPals, Jesper and Erlinge, David and Borgquist, Rasmus and Khoshnood, Ardavan and Ekelund, Ulf and Nickander, Jannike  and  Themudo, Raquel and Nordin, Sabrina and Kozor, Rebecca  and Moon, James and Maret, Eva  and Caidahl, Kenneth and Sigfridsson, Andreas and Sörensson, Peder and Schelbert, Erik B. and Arheden, Håkan and Ugander, Martin},
  keyword      = {MRI,Magnetic Resonance Imaging,Hyperthrophy},
  language     = {eng},
  location     = {Gothenburg, Sweden},
  title        = {Left ventricular global wall thickness is easily calculated, detects and characterizes hypertrophy, and has prognostic utility},
  year         = {2019},
}