Coronary artery diseaseLeft Ventricular Geometry and Survival in Patients With Normal Left Ventricular Ejection Fraction
Section snippets
Subject selection and echocardiography
We obtained relevant clinical and echocardiographic data from a clinical echocardiographic database of 42,508 studies that were recorded at Ochsner Clinic Foundation (New Orleans, Louisiana) between October 7, 1997 and November 20, 2002, and evaluated a subset of 35,602 patients who met the inclusion criteria of having a normal ejection fraction (≥50%), a United States residence, and absence of significant aortic stenosis. Survival status was obtained from the National Death Index in the entire
Baseline characteristics and patterns of LV geometry
Baseline characteristics of the cohort are listed in Table 1. Abnormal LV geometry was identified in 46% of all patients in the cohort. CR was the most frequently observed abnormal LV geometric pattern and was identified in 35% (n = 12,362) of the cohort (Figure 1).Table 2 presents the characteristics of patients grouped by LV geometry. Abnormal LV geometry was associated with older age and greater prevalence of obesity compared with subjects with normal geometry.
LV geometry and survival
There was a strong relation
Discussion
There are several important implications of this study. First, abnormal LV geometry, in particular CR, is a very common echocardiographic finding in the routine evaluation of patients with preserved LV ejection fraction. Second, the presence of CR in the general cardiovascular population, regardless of age or gender, confers a marked increase in all-cause mortality risk over time. Third, in patients who exhibit CR, further alteration of LV structure over time can have a significant effect on
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