Small Heart Size and Premature Death in 366,484 Individuals With Normal Ejection Fraction
2024

Small Heart Size and Premature Death

Sample size: 366484 publication 10 minutes Evidence: high

Author Information

Author(s): Rowe Stephanie J., Paratz Elizabeth D., Fahy Louise, Janssens Kristel, Spencer Luke W., D’Ambrosio Paolo, Strange Geoff, Prior David L., Playford David, Gerche Andre La

Primary Institution: HEART Lab, St Vincent’s Institute of Medical Research, Fitzroy, Australia

Hypothesis

Small cardiac size would be associated with premature mortality, particularly in those with high-normal LVEF and females would be more susceptible than males.

Conclusion

Small ventricular size is associated with increased mortality, especially among females and those with higher LVEF.

Supporting Evidence

  • Small heart size is linked to a 14% to 18% higher odds of 5-year all-cause mortality.
  • Females in the smallest LVEDVi quartile had a 30% increased odds of cardiovascular-related mortality.
  • Overall, 65,241 deaths occurred during approximately 2 million person-years of follow-up.

Takeaway

Having a small heart can make you more likely to die early, especially for women and those with a higher heart function.

Methodology

The study analyzed echocardiographic data from 366,484 individuals with normal LVEF and linked it to mortality outcomes from the National Death Index.

Potential Biases

Potential biases due to missing clinical information and reliance on echocardiographic measures.

Limitations

Clinical details such as heart failure diagnosis were not captured, and factors influencing cardiac size and risk were not assessed.

Participant Demographics

The cohort included 185,635 females (50.7%) and 180,849 males, with a median age of 61 years.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI: 0.765-0.838

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1016/j.jacadv.2024.101444

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