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Left Ventricular Mass and Incidence of Coronary Heart Disease in an Elderly Cohort: The Framingham Heart Study

Daniel Levy, MD; Robert J. Garrison, MS; Daniel D. Savage, MD, PhD; William B. Kannel, MD, MPH; and William P. Castelli, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Daniel Levy, MD, Framingham Heart Study, 118 Lincoln Street, Framingham, MA 01701.

Current Author Addresses: Drs. Levy and Castelli: Framingham Heart Study, 118 Lincoln Street, Framingham, MA 01701.

Dr. Garrison: Department of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Federal Bldg., Room 3A12, Bethesda, MD 20892.

Dr. Savage: National Center for Health Statistics, 3700 East-West Highway, Center Bldg., Room 1-43, Hyattsville, MD 20782.

Dr. Kannel: Evans Department of Clinical Research, University Hospital, 75 East Newton Street, Boston, MA 02118.

Ann Intern Med. 1989;110(2):101-107. doi:10.7326/0003-4819-110-2-101
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Objective: To examine the association of echocardiographically determined left ventricular mass with incidence of coronary heart disease in an elderly cohort.

Design: Cohort study with a follow-up period of 4 years.

Setting: Population-based.

Subjects: Elderly original volunteer subjects of the Framingham Heart Study who were free of clinically apparent coronary heart disease. This group included 406 men (mean age, 68 years; range, 60 to 90) and 735 women (mean age, 69 years; range, 59 to 90).

Measurements and Main Results: During 4 years of follow-up, coronary heart disease events occurred in 37 men and 33 women. Baseline echocardiographically determined left ventricular mass was associated with incidence of coronary disease in both sexes (P < 0.01). After adjusting for age, systolic blood pressure, smoking, and the ratio of total/high density lipoprotein cholesterol, the relative risk for a coronary event, per 50 g/m increment in left ventricular mass/height, was 1.67 in men (95% CI, 1.24 to 2.23) and 1.60 in women (95% CI, 1.10 to 2.32).

Conclusions: Echocardiographic assessment of left ventricular mass offers prognostic information beyond that provided by traditional risk factors, which can improve our ability to identify individuals at high risk for coronary heart disease. These findings may have widespread implications regarding the applications of echocardiography in clinical practice.





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