Inappropriate Left Ventricular Mass and Cardiovascular Disease Events and Mortality in Blacks: The Jackson Heart Study

Abstract

Background: Left ventricular hypertrophy (LVH) is associated with an increased risk for cardiovascular disease (CVD) events and all-cause mortality. Many individuals without LVH have a left ventricular mass that exceeds the level predicted by their sex, body size, and cardiac workload, a condition called inappropriate left ventricular mass (iLVM). We investigated the association of iLVM with CVD events and all-cause mortality among blacks. Methods and Results: We analyzed data from the Jackson Heart Study, a community-based cohort of blacks. The current analysis included 4424 participants without CVD and with an echocardiogram at baseline. Among this cohort, the prevalence of iLVM was 13.8%. There were 262 CVD events and 419 deaths over a median follow-up of 9.7 years (maximum, 12 years). Compared with participants without iLVM, participants with iLVM had a higher rate of CVD events and all-cause mortality. After multivariable adjustment, including for the presence of LVH, iLVM was associated with an increased risk of CVD events (hazard ratio, 1.87; 95% CI, 1.33–2.62). The multivariable-adjusted hazard ratio for all-cause mortality was 1.29 (95% CI, 0.98–1.70). Among participants without and with LVH, the multivariable-adjusted hazard ratios of iLVM for CVD events were 2.53 (95% CI, 1.68–3.81) and 1.21 (95% CI, 0.74–2.00), respectively (Pinteraction=0.029); and for all-cause mortality, the hazard ratios were 1.24 (95% CI, 0.81–1.89) and 1.26 (95% CI, 0.86–1.85), respectively (Pinteraction=0.664). Conclusions: iLVM is associated with an increased risk for CVD events among blacks without LVH.