Pandey A, et al. - Researchers investigated the independent and joint contribution of left ventricular hypertrophy and subclinical myocardial injury toward the risk of heart failure in African Americans in this longitudinal cohort study from the Jackson Heart Study cohort. The study included 3,987 participants (2,552 women [64%]; 240 [6.0%] with left ventricular hypertrophy [LVH]; 1,003 (25.1%) with myocardial injury) with 285 incident heart failure (HF) events over a median follow-up of 9.8 years. The combination of left ventricular hypertrophy and subclinical myocardial injury, as measured by high-sensitivity cardiac troponin assay, is correlated with very high absolute (35% incidence) and relative risk of heart failure (5-fold higher risk), particularly in African American men (15-fold higher risk). Outcomes thus suggest a potential utility of the combination of LVH and subclinical myocardial injury in identifying a malignant, subclinical heart failure phenotype and in could help with developing screening strategies to prevent heart failure in African Americans.