Association of small left ventricle with 1-year adverse cardiovascular outcomes in patients with coronary artery disease

Abstract

The prognosis of a small left ventricle (LV) in patients with coronary artery disease (CAD), as well as its inherent correlation with the occurrence of cardiovascular events, remains not fully investigated. To evaluate the association between a small LV and the risk of cardiovascular events in patients with coronary artery disease. We conducted a retrospective analysis of data from the Prospective Registry of the Current Status of Care for Patients with Coronary Artery Disease database, all participants with full data of conventional transthoracic echocardiography between Jan 2022 and Sep 2024 were collected. According to the American Society of Echocardiography guidelines, participants were categorized by left ventricular end-diastolic diameter (LVEDD) as having a small, normal (42.0–58.4 mm in men and 37.8–52.2 mm in women), or large LV. Cox proportional hazards models were used to assess the association between LV size and the 1-year major adverse cardiovascular events (MACE), defined as all-cause death, myocardial infarction, stroke or heart failure. Among 38,881 participants, 2,550 (6.6%) had a small LV, 35,299 (90.8%) normal, and 1,032 (2.7%) large. The small LV group exhibited older age, smaller stature, higher LVEF level. Compared with the normal LV group, both the small LV and large LV groups showed significantly increased rates of MACE (adjusted hazard ratio [aHR]: small LV: 1.45, 95% confidence interval [95% CI]: 1.16–1.80; large LV:1.54, 95% CI:1.20–1.97). The risk of all-cause death was also significantly elevated in the small LV group (aHR: 1.67, 95% CI: 1.27–2.21). Further analysis revealed a clear U-shaped association between LVEDD and MACE ( P nonlinear < 0.001). These findings indicating the association between small LV and high cardiovascular event risk in CAD patients, which provides new insights for optimizing prognostic management in this population.

The authors' abstract, as published at the source. BMC Cardiovascular Disorders, 2026 · DOI ↗