Association Between Size of Left Ventricle and Long-Term Cardiovascular Events.

Abstract

Background: The prognostic significance of small left ventricle (LV) in the general population and its association with cardiovascular disease remain elusive.

Methods: Using data from the UK Biobank, 39 363 participants underwent baseline cardiovascular magnetic resonance imaging and were categorized into 3 groups based on left ventricular end-diastolic volume index: small, normal, and large LV. Cox proportional hazards models were applied to evaluate the association between LV size and composite cardiovascular outcomes.

Results: An elevated prevalence of small LV was observed among the 4305 participants, with a notable trend toward increased occurrence in older individuals. Over a median follow-up of 5.21 years, 1500 cases of major adverse cardiovascular events, 1096 coronary heart disease, 288 ischemic stroke, and 722 deaths from any cause occurred. After adjusting for multiple confounders, hazard ratios (HRs) of small LV comparing the normal LV were 1.24 (95% CI, 1.07-1.44) for major adverse cardiovascular events, 1.29 (95% CI, 1.09-1.53) for coronary heart disease, 1.53 (95% CI, 1.11-2.09) for ischemic stroke, and 1.33 (95% CI, 1.08-1.64) for death from all causes. Notably, a U-shaped relationship was identified between left ventricular end-diastolic volume index and cardiovascular outcomes. Subgroup analysis revealed that, compared with women, the presence of a small LV in men exhibited a significant correlation with adverse cardiovascular events, thereby demonstrating potential value in disease prediction and risk stratification.

Conclusions: These findings highlight the importance of considering small LV as a prognostic marker for cardiovascular disease and underscore the need for further research to elucidate the underlying mechanisms and develop targeted interventions.