Concentric left ventricular hypertrophy as assessed by cardiac magnetic resonance imaging and risk of death in cardiac transplant recipients

Parag C. Patel, Sharon C Reimold, Faris G Araj, Colby R. Ayers, Patricia A. Kaiser, Ronald M Peshock, Clyde W. Yancy, W Steves Ring, Sachin Gupta, Joseph D. Mishkin, Pradeep P Mammen, David W. Markham, Mark H Drazner

Research output: Contribution to journalArticle

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Abstract

Background: Although risk factors for left ventricular (LV) hypertrophy in the native heart are well known, as is its association with increased risk of adverse outcomes, such information is poorly defined in heart transplant (HTx) recipients. We determined whether increased LV mass and concentricity (mass/volume) were associated with death in patients after HTx. Methods: Between May 2003 and May 2006, 140 HTx recipients underwent cardiac magnetic resonance imaging (MRI). Clinical characteristics associated with increased LV mass were determined. Cox proportional hazard models were constructed to assess the relationship of LV mass and concentricity with death. Results: MRIs were acquired a median of 6.0 years after transplant. The top quartile of indexed LV mass and concentricity were 35.8 g/m2.7 or higher and 1.5 g/ml or higher, respectively. History of rejection (odds ratio [OR], 5.9; 95% confidence interval [CI], 2.116.4; p < 0.01), diabetes (OR, 3.3; 95% CI, 1.38.2; p = 0.01), and post-transplant year of MRI acquisition (OR, 1.2; 95% CI, 1.11.4; p < 0.01) were associated with the top quartile of LV mass in multivariable models. LV mass and concentricity were independently associated with cardiovascular death (hazard risk [HR], 1.11 per g/m;2.7 HR, 10.1 per g/ml, p ≤ 0.01, respectively). LV concentricity was independently associated with all-cause mortality (HR, 4.4 per g/ml, p < 0.01). Conclusion: A history of rejection and diabetes are associated with increased LV mass. Increased LV mass, particularly of a concentric phenotype, is an independent risk factor for cardiovascular and all-cause mortality after HTx.

Original languageEnglish (US)
Pages (from-to)1369-1379
Number of pages11
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number12
DOIs
StatePublished - Dec 2010

Fingerprint

Left Ventricular Hypertrophy
Magnetic Resonance Imaging
Odds Ratio
Confidence Intervals
Transplants
Mortality
Proportional Hazards Models
Phenotype
Transplant Recipients

Keywords

  • diastole
  • humans
  • imaging
  • left ventricular hypertrophy
  • magnetic resonance
  • mortality
  • multivariate analysis
  • prognosis
  • transplantation

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Concentric left ventricular hypertrophy as assessed by cardiac magnetic resonance imaging and risk of death in cardiac transplant recipients. / Patel, Parag C.; Reimold, Sharon C; Araj, Faris G; Ayers, Colby R.; Kaiser, Patricia A.; Peshock, Ronald M; Yancy, Clyde W.; Ring, W Steves; Gupta, Sachin; Mishkin, Joseph D.; Mammen, Pradeep P; Markham, David W.; Drazner, Mark H.

In: Journal of Heart and Lung Transplantation, Vol. 29, No. 12, 12.2010, p. 1369-1379.

Research output: Contribution to journalArticle

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abstract = "Background: Although risk factors for left ventricular (LV) hypertrophy in the native heart are well known, as is its association with increased risk of adverse outcomes, such information is poorly defined in heart transplant (HTx) recipients. We determined whether increased LV mass and concentricity (mass/volume) were associated with death in patients after HTx. Methods: Between May 2003 and May 2006, 140 HTx recipients underwent cardiac magnetic resonance imaging (MRI). Clinical characteristics associated with increased LV mass were determined. Cox proportional hazard models were constructed to assess the relationship of LV mass and concentricity with death. Results: MRIs were acquired a median of 6.0 years after transplant. The top quartile of indexed LV mass and concentricity were 35.8 g/m2.7 or higher and 1.5 g/ml or higher, respectively. History of rejection (odds ratio [OR], 5.9; 95{\%} confidence interval [CI], 2.116.4; p < 0.01), diabetes (OR, 3.3; 95{\%} CI, 1.38.2; p = 0.01), and post-transplant year of MRI acquisition (OR, 1.2; 95{\%} CI, 1.11.4; p < 0.01) were associated with the top quartile of LV mass in multivariable models. LV mass and concentricity were independently associated with cardiovascular death (hazard risk [HR], 1.11 per g/m;2.7 HR, 10.1 per g/ml, p ≤ 0.01, respectively). LV concentricity was independently associated with all-cause mortality (HR, 4.4 per g/ml, p < 0.01). Conclusion: A history of rejection and diabetes are associated with increased LV mass. Increased LV mass, particularly of a concentric phenotype, is an independent risk factor for cardiovascular and all-cause mortality after HTx.",
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author = "Patel, {Parag C.} and Reimold, {Sharon C} and Araj, {Faris G} and Ayers, {Colby R.} and Kaiser, {Patricia A.} and Peshock, {Ronald M} and Yancy, {Clyde W.} and Ring, {W Steves} and Sachin Gupta and Mishkin, {Joseph D.} and Mammen, {Pradeep P} and Markham, {David W.} and Drazner, {Mark H}",
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T1 - Concentric left ventricular hypertrophy as assessed by cardiac magnetic resonance imaging and risk of death in cardiac transplant recipients

AU - Patel, Parag C.

AU - Reimold, Sharon C

AU - Araj, Faris G

AU - Ayers, Colby R.

AU - Kaiser, Patricia A.

AU - Peshock, Ronald M

AU - Yancy, Clyde W.

AU - Ring, W Steves

AU - Gupta, Sachin

AU - Mishkin, Joseph D.

AU - Mammen, Pradeep P

AU - Markham, David W.

AU - Drazner, Mark H

PY - 2010/12

Y1 - 2010/12

N2 - Background: Although risk factors for left ventricular (LV) hypertrophy in the native heart are well known, as is its association with increased risk of adverse outcomes, such information is poorly defined in heart transplant (HTx) recipients. We determined whether increased LV mass and concentricity (mass/volume) were associated with death in patients after HTx. Methods: Between May 2003 and May 2006, 140 HTx recipients underwent cardiac magnetic resonance imaging (MRI). Clinical characteristics associated with increased LV mass were determined. Cox proportional hazard models were constructed to assess the relationship of LV mass and concentricity with death. Results: MRIs were acquired a median of 6.0 years after transplant. The top quartile of indexed LV mass and concentricity were 35.8 g/m2.7 or higher and 1.5 g/ml or higher, respectively. History of rejection (odds ratio [OR], 5.9; 95% confidence interval [CI], 2.116.4; p < 0.01), diabetes (OR, 3.3; 95% CI, 1.38.2; p = 0.01), and post-transplant year of MRI acquisition (OR, 1.2; 95% CI, 1.11.4; p < 0.01) were associated with the top quartile of LV mass in multivariable models. LV mass and concentricity were independently associated with cardiovascular death (hazard risk [HR], 1.11 per g/m;2.7 HR, 10.1 per g/ml, p ≤ 0.01, respectively). LV concentricity was independently associated with all-cause mortality (HR, 4.4 per g/ml, p < 0.01). Conclusion: A history of rejection and diabetes are associated with increased LV mass. Increased LV mass, particularly of a concentric phenotype, is an independent risk factor for cardiovascular and all-cause mortality after HTx.

AB - Background: Although risk factors for left ventricular (LV) hypertrophy in the native heart are well known, as is its association with increased risk of adverse outcomes, such information is poorly defined in heart transplant (HTx) recipients. We determined whether increased LV mass and concentricity (mass/volume) were associated with death in patients after HTx. Methods: Between May 2003 and May 2006, 140 HTx recipients underwent cardiac magnetic resonance imaging (MRI). Clinical characteristics associated with increased LV mass were determined. Cox proportional hazard models were constructed to assess the relationship of LV mass and concentricity with death. Results: MRIs were acquired a median of 6.0 years after transplant. The top quartile of indexed LV mass and concentricity were 35.8 g/m2.7 or higher and 1.5 g/ml or higher, respectively. History of rejection (odds ratio [OR], 5.9; 95% confidence interval [CI], 2.116.4; p < 0.01), diabetes (OR, 3.3; 95% CI, 1.38.2; p = 0.01), and post-transplant year of MRI acquisition (OR, 1.2; 95% CI, 1.11.4; p < 0.01) were associated with the top quartile of LV mass in multivariable models. LV mass and concentricity were independently associated with cardiovascular death (hazard risk [HR], 1.11 per g/m;2.7 HR, 10.1 per g/ml, p ≤ 0.01, respectively). LV concentricity was independently associated with all-cause mortality (HR, 4.4 per g/ml, p < 0.01). Conclusion: A history of rejection and diabetes are associated with increased LV mass. Increased LV mass, particularly of a concentric phenotype, is an independent risk factor for cardiovascular and all-cause mortality after HTx.

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KW - humans

KW - imaging

KW - left ventricular hypertrophy

KW - magnetic resonance

KW - mortality

KW - multivariate analysis

KW - prognosis

KW - transplantation

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