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

• Published in: Journal of the American Heart Association Vol. 14; no. 15; p. e040490
• Main Authors: Cheng, Yun‐Jiu, Liao, Zi‐Li, Liu, Li‐Juan, Ma, Yue‐Dong, Chen, Xu‐Miao, Wu, Ze‐Xuan, Wei, Hui‐Qiang, Lin, Wei‐Dong, Liao, Yi‐Jian, Wu, Su‐Hua, Xue, Yu‐Mei, Wang, Li‐Chun, Wu, Yang
• Format: Journal Article
• Language: English
• Published: England Wiley 05.08.2025
• Subjects: Aged; cardiac magnetic resonance imaging; cardiovascular disease; Cardiovascular Diseases - epidemiology; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Heart Ventricles - physiopathology; Humans; left ventricular end‐diastolic volume index; Magnetic Resonance Imaging; Male; Middle Aged; Organ Size; Prevalence; Prognosis; Risk Assessment; Risk Factors; small left ventricle; Stroke Volume; Time Factors; United Kingdom - epidemiology; Ventricular Function, Left; United Kingdom; small left ventricle; cardiovascular disease; left ventricular end‐diastolic volume index; cardiac magnetic resonance imaging
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.124.040490

The prognostic significance of small left ventricle (LV) in the general population and its association with cardiovascular disease remain elusive. 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. 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. 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.