Cited by 402Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementCardiac Fibrosis and Remodeling

Left ventricular dilatation and the risk of congestive heart failure in people without myocardial infarction

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Vasan, Ramachandran S., Larson, Martin G., Benjamin, Emelia J., Evans, Jane C., Levy, Daniel·1997·New England Journal of Medicine

Abstract

BACKGROUND: Left ventricular dilatation is a well-recognized precursor of ventricular dysfunction and congestive heart failure after myocardial infarction. The effect of left ventricular dilatation on the risk of heart failure in people initially free of myocardial infarction is not known. METHODS: We examined the relation of the left ventricular end-diastolic and end-systolic internal dimensions, as measured by M-mode echocardiography, to the risk of congestive heart failure in 4744 subjects (2083 men and 2661 women) who had not sustained a myocardial infarction and who were free of congestive heart failure. We used sex-stratified proportional-hazards regression to assess the association between base-line left ventricular internal dimensions and the subsequent risk of congestive heart failure, after adjusting for age, blood pressure, hypertension treatment, body-mass index, diabetes, valve disease, and interim myocardial infarction. RESULTS: Over an 11-year follow-up period, congestive heart failure developed in 74 subjects (38 men and 36 women). The risk-factor-adjusted hazard ratio for congestive heart failure was 1.47 (95 percent confidence interval, 1.25 to 1.73) for an increment of 1 SD in the left ventricular end-diastolic dimension, indexed for height. We obtained similar results using the left ventricular end-systolic dimension (hazard ratio, 1.43; 95 percent confidence interval, 1.24 to 1.65). CONCLUSIONS: An increase in left ventricular internal dimension is a risk factor for congestive heart failure in men and women who have not had a myocardial infarction. Knowledge of the left ventricular dimension improves predictions of the risk of congestive heart failure made on the basis of traditional risk factors, perhaps by aiding in the identification of subjects with subclinical left ventricular dysfunction.

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Crossref · 10.1056/nejm199705083361903

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Authors
Vasan, R. S., Larson, M. G., Benjamin, E. J., Evans, J. C., & Levy, D.
Affiliations
Boston University (US)
Venue
New England Journal of Medicine
Published
1997-05-08
Volume
336
Issue
19
Pages
1350-1355
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2335083084
Cited by
402
References
31
Citations by year
2026: 8 · 2025: 8 · 2024: 14 · 2023: 9 · 2022: 13 · 2021: 17 · 2020: 13 · 2019: 14 · 2018: 8 · 2017: 11 · 2016: 11 · 2015: 6 · 2014: 14 · 2013: 11 · 2012: 9
FWCI
7.79
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (N0I-HC-38038)
  • National Institute of Neurological Disorders and Stroke (2-ROI-NS-17950-11)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords
left ventricular dilatation, congestive heart failure, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, subclinical left ventricular dysfunction, heart failure risk factors, myocardial infarction, M-mode echocardiography, sex differences
MeSH terms
Female, Follow-Up Studies, Heart Failure, Heart Ventricles, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Ultrasonography, Multivariate Analysis, Proportional Hazards Models, Hypertrophy, Left Ventricular

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