Background: Ischemic heart disease (IHD) is a leading cause of global cardiovascular mortality. Left ventricular (LV) remodeling, quantifiable through changes in left ventricular mass index (LVMI) and relative wall thickness (RWT), is a pivotal pathological process linking ischemia to clinical outcomes. Objectives: This narrative review aims to synthesize the current evidence on the pathophysiological mechanisms, prognostic value, and clinical implications of LV mass, LVMI, and RWT across the spectrum of IHD. Methods: We performed a comprehensive narrative synthesis of evidence from relevant studies identified through systematic searches of major biomedical databases. Results: Convergent evidence confirms that LVMI and RWT are robust, independent predictors of adverse cardiovascular events in IHD. Concentric hypertrophy (elevated LVMI with elevated RWT) consistently confers the highest risk across imaging modalities. These parameters provide incremental prognostic value beyond traditional risk factors, and their dynamic trajectory offers critical insights into therapeutic response. Conclusions: The integrated assessment of LVMI and RWT is crucial for risk stratification and personalized management in IHD. Future research should prioritize establishing standardized, modality-specific therapeutic targets and validating their role as surrogate endpoints in clinical trials.
Zhang et al. (Fri,) studied this question.