Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events

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...

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Main Authors: Yun‐Jiu Cheng, Zi‐Li Liao, Li‐Juan Liu, Yue‐Dong Ma, Xu‐Miao Chen, Ze‐Xuan Wu, Hui‐Qiang Wei, Wei‐Dong Lin, Yi‐Jian Liao, Su‐Hua Wu, Yu‐Mei Xue, Li‐Chun Wang, Yang Wu
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.040490
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author Yun‐Jiu Cheng
Zi‐Li Liao
Li‐Juan Liu
Yue‐Dong Ma
Xu‐Miao Chen
Ze‐Xuan Wu
Hui‐Qiang Wei
Wei‐Dong Lin
Yi‐Jian Liao
Su‐Hua Wu
Yu‐Mei Xue
Li‐Chun Wang
Yang Wu
author_facet Yun‐Jiu Cheng
Zi‐Li Liao
Li‐Juan Liu
Yue‐Dong Ma
Xu‐Miao Chen
Ze‐Xuan Wu
Hui‐Qiang Wei
Wei‐Dong Lin
Yi‐Jian Liao
Su‐Hua Wu
Yu‐Mei Xue
Li‐Chun Wang
Yang Wu
author_sort Yun‐Jiu Cheng
collection DOAJ
description 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.
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spelling doaj-art-547ba3292ed24fcf83e04865a96eb4af2025-08-20T03:59:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141510.1161/JAHA.124.040490Association Between Size of Left Ventricle and Long‐Term Cardiovascular EventsYun‐Jiu Cheng0Zi‐Li Liao1Li‐Juan Liu2Yue‐Dong Ma3Xu‐Miao Chen4Ze‐Xuan Wu5Hui‐Qiang Wei6Wei‐Dong Lin7Yi‐Jian Liao8Su‐Hua Wu9Yu‐Mei Xue10Li‐Chun Wang11Yang Wu12Department of Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaDepartment of Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaThe First Clinical Medical College, Guangdong Medical University Zhanjiang ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaGuangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou Guangdong ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaDepartment of Cardiology, the First Affiliated Hospital Sun Yat‐Sen University Guangzhou ChinaBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.124.040490cardiac magnetic resonance imagingcardiovascular diseaseleft ventricular end‐diastolic volume indexsmall left ventricle
spellingShingle Yun‐Jiu Cheng
Zi‐Li Liao
Li‐Juan Liu
Yue‐Dong Ma
Xu‐Miao Chen
Ze‐Xuan Wu
Hui‐Qiang Wei
Wei‐Dong Lin
Yi‐Jian Liao
Su‐Hua Wu
Yu‐Mei Xue
Li‐Chun Wang
Yang Wu
Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiac magnetic resonance imaging
cardiovascular disease
left ventricular end‐diastolic volume index
small left ventricle
title Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
title_full Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
title_fullStr Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
title_full_unstemmed Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
title_short Association Between Size of Left Ventricle and Long‐Term Cardiovascular Events
title_sort association between size of left ventricle and long term cardiovascular events
topic cardiac magnetic resonance imaging
cardiovascular disease
left ventricular end‐diastolic volume index
small left ventricle
url https://www.ahajournals.org/doi/10.1161/JAHA.124.040490
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