Prognostic Implications of Left Ventricular Mass Among Hispanics

Abstract

Hispanics may carry a similar burden of increased left ventricular mass (LVM) as non-Hispanic blacks but whether LVM portends a worse outcome among Hispanics is largely unknown. We prospectively evaluated 1081 Hispanics enrolled in the Northern Manhattan Study during the period of 1993 to 2001. Subjects were aged ≥40 years and free of prior myocardial infarction or stroke. LVM was defined echocardiographically and indexed for height ^2.7 . Cox proportional hazards models were used to assess the risk of vascular events with adjustments for age, gender, systolic blood pressure, diabetes, and smoking. LVM averaged 48.4±15 gm/ht ^2.7 and on multivariate analysis was significantly associated with the combined end point of myocardial infarction, stroke, or vascular death (adjusted hazard ratio 1.34 per SD change in LVM [95% CI 1.10 to 1.63]). During a mean of 57 months of follow-up, 74 vascular events occurred. The annual rate of vascular events was 21.8 per 1000 patient-years in the highest quartile of LVM and 8.6 per 1000 patient-years in the lowest quartile ( P =0.007). These data demonstrate in a large population-based sample that increased LVM yields independent prognostic information among Hispanics, predicting a higher incidence of events attributable to vascular disease in this understudied population. Our findings identify the Hispanic population with increased LVM as a high-risk subgroup.