Left Ventricular Hypertrophy, Subclinical Myocardial Injury, and Risk of Heart Failure Among African-Americans

By Ambarish Pandey, M.D.

Assistant Professor of Internal Medicine

At this year’s AHA Scientific Sessions, we presented findings from our study evalu­ating the contributions of left ventricular hypertrophy and subclinical myocardial injury toward risk of heart failure among African-Americans in the Jackson Heart Study. Heart fail­ure risk factors and clinical heart failure are more common among African-Americans than other race/ethnic groups.

Our study found that in African-Americans, both left ventricular hypertrophy and subclinical myocardial injury were independently associ­ated with an increased risk of heart failure. Furthermore, there was a synergistic interaction between left ventricular mass and burden of subclinical myocardial injury for the risk of heart failure such that the individuals with both left ventricular hypertrophy and myocardial injury had a very high risk of heart failure.

The malignant phenotype of left ventricular hypertrophy with coexisting subclinical myocar­dial injury was present in 3 percent of the study participants at baseline, and up to one-third of participants with this phenotype developed heart failure over 10 years follow-up. Our study findings underscore the importance of screening strategies to identify this malignant phenotype in targeting of heart failure prevention efforts to the highest-risk African-Americans who might benefit from aggressive preventive interventions.