Inappropriate Left Ventricular Mass and Cardiovascular Disease Events and Mortality in Blacks: The Jackson Heart Study

Abstract

Background Left ventricular hypertrophy (LVH) is associated with an increased risk for cardiovascular disease (CVD) events and all‐cause mortality. Many individuals without LVH have a left ventricular mass that exceeds the level predicted by their sex, body size, and cardiac workload, a condition called inappropriate left ventricular mass (iLVM). We investigated the association of iLVM with CVD events and all‐cause mortality among blacks. Methods and Results We analyzed data from the Jackson Heart Study, a community‐based cohort of blacks. The current analysis included 4424 participants without CVD and with an echocardiogram at baseline. Among this cohort, the prevalence of iLVM was 13.8%. There were 262 CVD events and 419 deaths over a median follow‐up of 9.7 years (maximum, 12 years). Compared with participants without iLVM, participants with iLVM had a higher rate of CVD events and all‐cause mortality. After multivariable adjustment, including for the presence of LVH, iLVM was associated with an increased risk of CVD events (hazard ratio, 1.87; 95% CI, 1.33–2.62). The multivariable‐adjusted hazard ratio for all‐cause mortality was 1.29 (95% CI, 0.98–1.70). Among participants without and with LVH, the multivariable‐adjusted hazard ratios of iLVM for CVD events were 2.53 (95% CI, 1.68–3.81) and 1.21 (95% CI, 0.74–2.00), respectively (Pinteraction=0.029); and for all‐cause mortality, the hazard ratios were 1.24 (95% CI, 0.81–1.89) and 1.26 (95% CI, 0.86–1.85), respectively (Pinteraction=0.664). Conclusions iLVM is associated with an increased risk for CVD events among blacks without LVH.

Keywords

• black
• cardiovascular disease
• inappropriate left ventricular mass
• left ventricular hypertrophy
• mortality