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Lavie CJ et al. - Although abnormal LV geometry and LVH progressively increased with more obesity, total mortality was strongly and inversely related with BMI. However, in each BMI subgroup, mortality progressively increased with abnormal LV geometry from normal, CR, eccentric LVH, and concentric LVH. In a multivariate analysis, abnormal LV geometry, including increased relative wall thickness and LV mass index, and lower BMI were independent predictors of mortality. Although an obesity paradox exists, in that obesity is associated with abnormal LV geometry but lower mortality, these data demonstrate that LV geometric abnormalities are prevalent in elderly patients with preserved systolic function and are associated with progressive increases in mortality.

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