Heart failure & cardiomyopathiesCohort study
U-Shaped Association Between Left Ventricular Dimension and Mortality in Patients With Heart Failure
- Prospective cohort study
- nationwide
- multicentre
- 723 centres
Authors' conclusion
This large-scale study established that a U-shaped association exists between LVEDD and mortality in HF, suggesting that both abnormally small and abnormally large ventricles signify high risk, likely through distinct mechanisms.
Study context
- Population
- Patients hospitalised with heart failure (HF), Chinese Cardiovascular Association Database-Heart Failure Center Registry, 723 centres in mainland China, 2018–2022
- Participants
- 273,921 patients
- Exposure
- Small or large left ventricle (LV) vs normal LV
- Outcome
- All-cause mortality
Main finding
As reported in the abstract
Each group vs normal LVAdjusted hazard ratio (95% CI)P value
Small LV
1.32(1.28–1.37)
P < 0.001Large LV
1.38(1.35–1.40)
P < 0.001- U-shaped association between LV end-diastolic diameter (LVEDD) and all-cause and CV mortality (P for nonlinearity)
- <.001
Observational data: associations, not effects.
Secondary outcomes
Sex-specific optimal LVEDD thresholds
mm
- Optimal LVEDD, male patients
- 47
- Optimal LVEDD, female patients
- 43
- Each 1-mm deviation associated with a significant increase in mortality risk
Prespecified subgroups, LVEDD indexed to BSA and sensitivity analyses
- Findings consistent across prespecified subgroups and corroborated by indexed LVEDD and sensitivity analyses
Original publication
U-Shaped Association Between Left Ventricular Dimension and Mortality in Patients With Heart Failure. JAMA Cardiol. Published 5 August 2026. doi:10.1001/jamacardio.2026.2779
Summarised from the published abstract; every number is checked against it