Clinical impact of ‘in-treatment’ wall motion abnormalities in hypertensive patients with left ventricular hypertrophy: the LIFE study
- 1 April 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Hypertension
- Vol. 26 (4), 806-812
- https://doi.org/10.1097/hjh.0b013e3282f4b3a9
Abstract
Left ventricular systolic wall motion abnormalities have prognostic value. Whether wall motion detected by serial echocardiographic examinations predicts prognosis in hypertensive patients with left ventricular hypertrophy (LVH) without clinically recognized atherosclerotic disease has, however, never been investigated. We examined whether 'in-treatment' wall motion abnormalities predicted outcome in the Losartan Intervention For Endpoint (LIFE) reduction in hypertension echocardiographic substudy. We studied 749 patients without coronary artery disease, myocardial infarction (MI), or stroke history. Echocardiographic segmental wall motion abnormalities at baseline and annual re-evaluations ('as time-varying covariate') were examined in relation to endpoints (cardiovascular mortality, MI, stroke, and hospitalized heart failure). Adjusted Cox regression was used to analyze the primary composite endpoint of cardiovascular death, MI, or stroke and, separately, for fatal and nonfatal MI and hospitalized heart failure. During a mean follow-up of 4.8 years, an event was recorded in 67 (9%) patients. In Cox models after adjusting for age, gender, treatment, blood pressure lowering, and serial change of left ventricular mass index, 'in-treatment' segmental wall motion abnormalities were associated with subsequent composite endpoint [hazard ratio = 2.1, 95% confidence interval (CI) 1.1-3.8; P = 0.019] and MI [hazard ratio = 3.7 (1.5-8.9); P = 0.004]. In hypertensive patients with LVH and no history of cardiovascular disease, 'in-treatment' left ventricular wall motion abnormalities are associated with increased likelihood of subsequent cardiovascular events independent of age, gender, blood pressure lowering, treatment modality, and in-treatment left ventricular mass index.Keywords
This publication has 28 references indexed in Scilit:
- Population impact of losartan use on stroke in the European Union (EU): Projections from the Losartan Intervention For Endpoint reduction in hypertension (LIFE) studyJournal of Human Hypertension, 2004
- Echocardiographic Wall Motion Abnormalities in Hypertensive Patients With Electrocardiographic Left Ventricular HypertrophyHypertension, 2003
- Prognostic usefulness of repeated echocardiographic evaluation after acute myocardial infarctionThe American Journal of Cardiology, 1999
- Clinical impact of echocardiography in prognostic stratification after acute myocardial infarctionThe American Journal of Cardiology, 1998
- Prognostic Value of Echocardiography in 190 Patients with Chronic Congestive Heart FailureJMIR AI, 1996
- Angina Due to Coronary Microvascular Disease in Hypertensive Patients without Left Ventricular HypertrophyNew England Journal of Medicine, 1988
- A comparison of quantitative echocardiographic methods for delineating infarct-induced abnormal wall motion.Circulation, 1984
- Prognostic value of predischarge 2-dimensional echocardiogram after acute myocardial infarctionThe American Journal of Cardiology, 1984
- The stunned myocardium: prolonged, postischemic ventricular dysfunction.Circulation, 1982
- Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.Circulation, 1978