Previous studies have identified a number of echocardiographic variables that predict
cardiovascular disease (CVD) events and mortality, but have not focused on a large
elderly cohort. The purpose of this study was to determine whether M-mode echocardiographic
variables predicted all-cause mortality, incident coronary heart disease (CHD), congestive
heart failure (CHF), and stroke in a large prospective, multicenter, population-based
study. In the Cardiovascular Health Study, a biracial cohort of 5,888 men and women
(mean age 73 years) underwent 2-dimensional M-mode echocardiographic measurements
of left ventricular (LV) internal dimensions, wall thickness, mass and geometry, as
well as measurement of left atrial dimension and assessment for mitral annular calcium.
Participants were followed for 6 to 7 years for incident events; analyses excluded
subjects with prevalent disease. One or more echocardiographic measurements were independent
predictors of all-cause mortality and incident CHD, CHF, and stroke. After adjustment
for anthropometric and traditional CVD risk factors, LV mass was significantly related
to incident CHD, CHF, and stroke. The highest quartile of LV mass conferred a hazards
ratio of 3.36, compared with the lowest quartile, for incident CHF. Furthermore, incident
CHF-free survival was significantly lower for participants with LV mass in the highest
versus the 2 lowest quartiles (86% vs 97%, respectively, at 2,500 days). Eccentric
and concentric LV hypertrophy, respectively, conferred adjusted hazards ratios, compared
with normal LV geometry, of 2.05 and 1.61 for incident CHD, and 2.95 and 3.32 for
incident CHF. Thus, in an elderly biracial population, selected 2-dimensional M-mode
echocardiographic measurements were important markers of subclinical disease and conferred
independent prognostic information for incident CVD events, especially CHF and CHD.