Abstract
Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
| Original language | English |
|---|---|
| Pages (from-to) | 918-928 |
| Number of pages | 11 |
| Journal | Korean Circulation Journal |
| Volume | 47 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2017 Nov |
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All Science Journal Classification (ASJC) codes
- Internal Medicine
- Cardiology and Cardiovascular Medicine
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Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy. / Cho, In Jeong; Chang, Hyuk Jae; Lee, Sang Eun; Shim, Chi Young; Hong, Geu Ru; Chung, Namsik.
In: Korean Circulation Journal, Vol. 47, No. 6, 11.2017, p. 918-928.Research output: Contribution to journal › Article
TY - JOUR
T1 - Prognostic application of thoracic aortic calcium scoring for adverse clinical outcome risk in elderly patients with left ventricular hypertrophy
AU - Cho, In Jeong
AU - Chang, Hyuk Jae
AU - Lee, Sang Eun
AU - Shim, Chi Young
AU - Hong, Geu Ru
AU - Chung, Namsik
PY - 2017/11
Y1 - 2017/11
N2 - Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
AB - Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
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U2 - 10.4070/kcj.2016.0443
DO - 10.4070/kcj.2016.0443
M3 - Article
AN - SCOPUS:85039867777
VL - 47
SP - 918
EP - 928
JO - Korean Circulation Journal
JF - Korean Circulation Journal
SN - 1738-5520
IS - 6
ER -