Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study

Background Echocardiographic criteria of left ventricular hypertrophy (LVH) recommended in the international guidelines are derived from a White population, which could be less accurate in estimating LVH burden in other ethnic groups. Given that LVH is an important prognostic factor, assessing its b...

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Main Authors: Anping Cai, Congyi Zheng, Qingjie Song, Jiayuan Qiu, Xin Wang, Zhen Hu, Xue Cao, Yixin Tian, Runqing Gu, Xuyan Pei, Xue Yu, Chenye Chang, Nuerguli Tuerdi, Yujie Zhang, Ye Tian, Yingqing Feng, Zengwu Wang
Format: Article
Language:English
Published: Wiley 2025-04-01
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.124.038108
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author Anping Cai
Congyi Zheng
Qingjie Song
Jiayuan Qiu
Xin Wang
Zhen Hu
Xue Cao
Yixin Tian
Runqing Gu
Xuyan Pei
Xue Yu
Chenye Chang
Nuerguli Tuerdi
Yujie Zhang
Ye Tian
Yingqing Feng
Zengwu Wang
author_facet Anping Cai
Congyi Zheng
Qingjie Song
Jiayuan Qiu
Xin Wang
Zhen Hu
Xue Cao
Yixin Tian
Runqing Gu
Xuyan Pei
Xue Yu
Chenye Chang
Nuerguli Tuerdi
Yujie Zhang
Ye Tian
Yingqing Feng
Zengwu Wang
author_sort Anping Cai
collection DOAJ
description Background Echocardiographic criteria of left ventricular hypertrophy (LVH) recommended in the international guidelines are derived from a White population, which could be less accurate in estimating LVH burden in other ethnic groups. Given that LVH is an important prognostic factor, assessing its burden using ethnically specific criteria has important implications. We sought to evaluate the prevalence and prognostic implications of LVH based on the EMINCA (Echocardiographic Measurements in Normal Chinese Adults) study criteria and the international guidelines. Methods and Results Nationally representative populations aged ≥35 years (n=20 210; mean age, 56.0 years; 53.3% women) were enrolled from the China Hypertension Survey 2012 to 2015. The EMINCA study criteria for LVH were left ventricular mass index >109 g/m2 for men and >105 g/m2 for women; and the international guidelines criteria were left ventricular mass index >115 g/m2 for men and >95 g/m2 for women. Prevalence of LVH defined by the EMINCA study and international guidelines was 8.3% (≈56.8 million) and 11.7% (≈80.1 million), respectively. LVH defined by the EMINCA study was associated with adjusted hazard ratio (HR) of 1.55 (95% CI, 1.19–2.01; P<0.001) for cardiovascular death and 1.14 (95% CI, 0.95–1.37; P=0.16) for all‐cause death. LVH defined by the international guidelines was associated with adjusted HR of 1.31 (95% CI, 1.00–1.72; P=0.047) for cardiovascular death and 1.12 (95% CI, 0.94–1.34; P=0.22) for all‐cause death. Conclusions LVH diagnosis based on both criteria was independently associated with cardiovascular death. However, the prevalence of LVH in a general Chinese population varies significantly by the echocardiographic criteria.
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spelling doaj-art-9533a3b98d884e43b4494937e73a402e2025-08-20T02:33:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114810.1161/JAHA.124.038108Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based StudyAnping Cai0Congyi Zheng1Qingjie Song2Jiayuan Qiu3Xin Wang4Zhen Hu5Xue Cao6Yixin Tian7Runqing Gu8Xuyan Pei9Xue Yu10Chenye Chang11Nuerguli Tuerdi12Yujie Zhang13Ye Tian14Yingqing Feng15Zengwu Wang16Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDepartment of Epidemiology, School of Public Health Medical College of Soochow University Suzhou ChinaDepartment of Epidemiology, School of Public Health Medical College of Soochow University Suzhou ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaDepartment of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences Southern Medical University Guangzhou ChinaDivision of Prevention and Community Health, National Center for Cardiovascular Disease Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing ChinaBackground Echocardiographic criteria of left ventricular hypertrophy (LVH) recommended in the international guidelines are derived from a White population, which could be less accurate in estimating LVH burden in other ethnic groups. Given that LVH is an important prognostic factor, assessing its burden using ethnically specific criteria has important implications. We sought to evaluate the prevalence and prognostic implications of LVH based on the EMINCA (Echocardiographic Measurements in Normal Chinese Adults) study criteria and the international guidelines. Methods and Results Nationally representative populations aged ≥35 years (n=20 210; mean age, 56.0 years; 53.3% women) were enrolled from the China Hypertension Survey 2012 to 2015. The EMINCA study criteria for LVH were left ventricular mass index >109 g/m2 for men and >105 g/m2 for women; and the international guidelines criteria were left ventricular mass index >115 g/m2 for men and >95 g/m2 for women. Prevalence of LVH defined by the EMINCA study and international guidelines was 8.3% (≈56.8 million) and 11.7% (≈80.1 million), respectively. LVH defined by the EMINCA study was associated with adjusted hazard ratio (HR) of 1.55 (95% CI, 1.19–2.01; P<0.001) for cardiovascular death and 1.14 (95% CI, 0.95–1.37; P=0.16) for all‐cause death. LVH defined by the international guidelines was associated with adjusted HR of 1.31 (95% CI, 1.00–1.72; P=0.047) for cardiovascular death and 1.12 (95% CI, 0.94–1.34; P=0.22) for all‐cause death. Conclusions LVH diagnosis based on both criteria was independently associated with cardiovascular death. However, the prevalence of LVH in a general Chinese population varies significantly by the echocardiographic criteria.https://www.ahajournals.org/doi/10.1161/JAHA.124.038108left ventricular hypertrophyprevalenceprognosis
spellingShingle Anping Cai
Congyi Zheng
Qingjie Song
Jiayuan Qiu
Xin Wang
Zhen Hu
Xue Cao
Yixin Tian
Runqing Gu
Xuyan Pei
Xue Yu
Chenye Chang
Nuerguli Tuerdi
Yujie Zhang
Ye Tian
Yingqing Feng
Zengwu Wang
Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
left ventricular hypertrophy
prevalence
prognosis
title Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
title_full Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
title_fullStr Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
title_full_unstemmed Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
title_short Influence of Echocardiographic Criteria on the Prevalence and Prognostic Implication of Left Ventricular Hypertrophy: A Nationwide Population‐Based Study
title_sort influence of echocardiographic criteria on the prevalence and prognostic implication of left ventricular hypertrophy a nationwide population based study
topic left ventricular hypertrophy
prevalence
prognosis
url https://www.ahajournals.org/doi/10.1161/JAHA.124.038108
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