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M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study).

TitleM-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study).
Publication TypeJournal Article
Year of Publication2001
AuthorsGardin, JM, McClelland, R, Kitzman, D, Lima, JA, Bommer, W, Klopfenstein, HS, Wong, ND, Smith, VE, Gottdiener, J
JournalAm J Cardiol
Volume87
Issue9
Pagination1051-7
Date Published2001 May 01
ISSN0002-9149
KeywordsAged, Aged, 80 and over, Analysis of Variance, Coronary Disease, Echocardiography, Doppler, Female, Heart Failure, Humans, Incidence, Male, Predictive Value of Tests, Proportional Hazards Models, Prospective Studies, Risk Factors, Stroke
Abstract<p>Previous studies have identified a number of echocardiographic variables that predict cardiovascular disease (CVD) events and mortality, but have not focused on a large elderly cohort. The purpose of this study was to determine whether M-mode echocardiographic variables predicted all-cause mortality, incident coronary heart disease (CHD), congestive heart failure (CHF), and stroke in a large prospective, multicenter, population-based study. In the Cardiovascular Health Study, a biracial cohort of 5,888 men and women (mean age 73 years) underwent 2-dimensional M-mode echocardiographic measurements of left ventricular (LV) internal dimensions, wall thickness, mass and geometry, as well as measurement of left atrial dimension and assessment for mitral annular calcium. Participants were followed for 6 to 7 years for incident events; analyses excluded subjects with prevalent disease. One or more echocardiographic measurements were independent predictors of all-cause mortality and incident CHD, CHF, and stroke. After adjustment for anthropometric and traditional CVD risk factors, LV mass was significantly related to incident CHD, CHF, and stroke. The highest quartile of LV mass conferred a hazards ratio of 3.36, compared with the lowest quartile, for incident CHF. Furthermore, incident CHF-free survival was significantly lower for participants with LV mass in the highest versus the 2 lowest quartiles (86% vs 97%, respectively, at 2,500 days). Eccentric and concentric LV hypertrophy, respectively, conferred adjusted hazards ratios, compared with normal LV geometry, of 2.05 and 1.61 for incident CHD, and 2.95 and 3.32 for incident CHF. Thus, in an elderly biracial population, selected 2-dimensional M-mode echocardiographic measurements were important markers of subclinical disease and conferred independent prognostic information for incident CVD events, especially CHF and CHD.</p>
DOI10.1016/s0002-9149(01)01460-6
Alternate JournalAm J Cardiol
PubMed ID11348601
Grant ListHC-85086 / HC / NHLBI NIH HHS / United States
N01-85079 / / PHS HHS / United States