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Ventricular Geometry Predicts Outcome in Hypertension

Normalization of concentric remodeling confers better chances of survival

THURSDAY, April 27 (HealthDay News) -- In patients with hypertension, left ventricular (LV) geometry is a predictor of cardiovascular outcome, with better survival rates linked to normalization of concentric remodeling, and higher death risks associated with transition to LV hypertrophy, according to a study in the April issue of the American Journal of Cardiology.

Richard V. Milani, M.D., of the Ochsner Clinic Foundation in New Orleans, and colleagues conducted retrospective analysis of 35,602 patients who were referred for echocardiography, which is able to detect concentric remodeling in the absence of LV hypertrophy.

In 46 percent of patients, abnormal LV geometry was identified, including 35 percent (12,362 patients) with concentric remodeling and 11 percent (3,958 patients) with LV hypertrophy. Patients with abnormal LV geometry tended to be older and more obese than those with normal hypertrophy, and there was a strong relation between the condition and mortality, with the relative risk for all-cause mortality nearly double that of subjects with normal LV geometry.

Patients who progressed from concentric remodeling to LV hypertrophy had a higher mortality risk than those who went from concentric remodeling back to normal LV geometry.

"To date, this investigation represents the largest study of a clinical population with normal ejection fraction that has examined the magnitude or consequences of these LV geometric patterns," the authors write.

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