Objectives The goal of this study was to assess associations between left ventricular (LV) mass, all-cause mortality, and need for revascularization in patients undergoing coronary angiography.

Background LV hypertrophy is associated with adverse cardiovascular outcomes in healthy subjects. However, its influence in those with known or suspected coronary artery disease is poorly understood.

Methods A total of 3,754 patients (mean age 59.3 ± 13.1 years) undergoing invasive coronary angiography and cardiac magnetic resonance (CMR) (mean interval 1.0 ± 1.5 months) were studied. LV mass and volumes were determined from cine images and indexed to body surface area. Analyses were adjusted for CMR variables, medical comorbidities, and severity of coronary artery disease (Duke Jeopardy Score) and were stratified to LV function.

Results At a median of 44.9 months, 315 patients (8.4%) died and 168 patients (4.5%) underwent revascularization. Multivariable analysis showed that each 10 g/m² increase in LV mass index was associated with a 6% greater risk of mortality (hazard ratio: 1.06; 95% confidence interval [CI]: 1.01 to 1.11; p = 0.02) and a 10% greater need for revascularization (hazard ratio: 1.10; 95% CI: 1.04 to 1.17; p < 0.01). According to pre-defined thresholds, moderate to severe hypertrophy was associated with a 1.7-fold risk of mortality (95% CI: 1.2 to 2.3) and 1.8-fold need for revascularization (95% CI: 1.18 to 2.67). These findings were predominantly observed in those with a left ventricular ejection fraction >35% with respective hazard ratios of 2.93 (95% CI: 1.92 to 4.47) and 2.20 (95% CI: 1.21 to 3.98).

Conclusions LV mass index is an independent predictor of all-cause mortality and need for revascularization. This finding establishes relevance for LV mass measurements in clinical decision-making surrounding both the need and timing of revascularization in this population.

目的本研究的目的是评估冠状动脉造影患者左心室质量，全因死亡率和血运重建需求之间的关系。

背景LV肥大与健康受试者的不良心血管结果相关。但是，对于已知或疑似冠心病患者的影响知之甚少。

方法对3,754例平均年龄为59.3±13.1岁的患者行侵入性冠状动脉造影和心脏磁共振（CMR）（平均间隔为1.0±1.5个月）进行研究。从电影图像确定左心室质量和体积，并索引到体表面积。对CMR变量，医学合并症和冠状动脉疾病的严重程度（杜克·乔帕迪评分）进行分析调整，并根据LV功能进行分层。

结果平均44.9个月，有315例患者（8.4％）死亡，168例患者（4.5％）进行了血运重建。多变量分析表明，LV质量指数每升高10 g / m ²，死亡风险就会增加6％（危险比：1.06； 95％置信区间[CI]：1.01至1.11； p = 0.02）和10增加的血运重建需求百分比（危险比：1.10; 95％CI：1.04至1.17; p <0.01）。根据预先确定的阈值，中度至重度肥大与死亡风险有1.7倍相关（95％CI：1.2至2.3）和1.8倍的血运重建需要（95％CI：1.18至2.67）。这些发现主要在左心室射血分数> 35％的患者中观察到，其危险比分别为2.93（95％CI：1.92至4.47）和2.20（95％CI：1.21至3.98）。

结论LV质量指数是全因死亡率和血运重建需求的独立预测因子。这一发现建立了LV量度测量在临床决策中的相关性，该决策围绕着该人群血运重建的需要和时机。