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Abstract
Cardiovascular magnetic resonance (CMR) can accurately measure left ventricular (LV) mass, and several measures related to LV wall thickness exist. We hypothesized that prognosis can be used to select an optimal measure of wall thickness for characterizing LV hypertrophy. Subjects having undergone CMR were studied (cardiac patients, n = 2543; healthy volunteers, n = 100). A new measure, global wall thickness (GT, GTI if indexed to body surface area) was accurately calculated from LV mass and end-diastolic volume. Among patients with follow-up (n = 1575, median follow-up 5.4 years), the most predictive measure of death or hospitalization for heart failure was LV mass index (LVMI) (hazard ratio (HR)[95% confidence interval] 1.16[1.12–1.20], p < 0.001), followed by GTI (HR 1.14[1.09–1.19], p < 0.001). Among patients with normal findings (n = 326, median follow-up 5.8 years), the most predictive measure was GT (HR 1.62[1.35–1.94], p < 0.001). GT and LVMI could characterize patients as having a normal LV mass and wall thickness, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy, and the three abnormal groups had worse prognosis than the normal group (p < 0.05 for all). LV mass is highly prognostic when mass is elevated, but GT is easily and accurately calculated, and adds value and discrimination amongst those with normal LV mass (early disease).
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1 Karolinska University Hospital, and Karolinska Institutet, Department of Clinical Physiology, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626)
2 Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361); Lund University, Wallenberg Center for Molecular Medicine, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
3 Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
4 Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Clinical Physiology, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361); Lund University, Department of Health Sciences, Physiotherapy, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
5 University of Oslo, Department of Cardiology, and Institute of Clinical Medicine, Oslo University Hospital Ulleval, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921)
6 Lund University, Arrhythmia Clinic, Skåne University Hospital, and Department of Cardiology, Clinical Sciences, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
7 Lund University, Skåne University Hospital, Department of Clinical Sciences, Cardiology, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
8 Lund University, Skåne University Hospital, Department of Clinical Sciences, Emergency and Internal Medicine, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
9 University College London, Institute of Cardiovascular Science, London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201)
10 Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)
11 University College London, Institute of Cardiovascular Science, London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201); Barts Heart Centre, Department of Cardiology, London, UK (GRID:grid.501049.9)
12 Karolinska University Hospital, and Karolinska Institutet, Department of Clinical Physiology, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626); University of Gothenburg and Clinical Physiology, Sahlgrenska University Hospital, Institute of Medicine, Gothenburg, Sweden (GRID:grid.1649.a) (ISNI:000000009445082X)
13 Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden (GRID:grid.24381.3c) (ISNI:0000 0000 9241 5705); Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626)
14 University of Pittsburgh Medical Center, Pittsburgh, USA (GRID:grid.412689.0) (ISNI:0000 0001 0650 7433)
15 Karolinska University Hospital, and Karolinska Institutet, Department of Clinical Physiology, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626); Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Sydney, Royal North Shore Hospital, St Leonards, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)