Abstract 16799: Left Ventricular Hypertrophy in South African Adults and Children

Abstract

Introduction: Left ventricular hypertrophy (LVH) increases risk of heart failure and sudden cardiac death. Specific changes in LV geometry and relative wall thickness (RWT) may provide additional prognostic information. As routine echocardiography may not typically be available in low-resource settings, we aimed to identify the factors associated with LVH presence and LV remodelling within adults (n=108; age 29-68 years) and children (n=56; age 4-10) in an urban cohort from a historically disadvantaged township in South Africa. Methods: Anthropometry and blood pressure (BP) were measured in triplicate, and self-reported diabetes mellitus, previous heart disease and hypertension medication, tobacco and alcohol use were recorded. LV mass was assessed at end-diastole perpendicular to the long axis of the LV and indexed to body surface area (LVMI). Prevalence of LVH (defined as LVMI>95g/m 2 for adults and LVMI >88.9g/m 2 [95 th percentile] for children), eccentric LVH (LVH with RWT<=0.42) and concentric LVH (LVH with RWT>0.42) and concentric remodelling (normal LVMI with RWT>0.42) was recorded. For adults, hypertension was defined as BP ≥140/90 mmHg or on medication and for children using American Academy of Paediatrics Guidelines (2019). Body mass index (BMI) was calculated as weight (kg)/height(m) 2 . Results: LVH prevalence was 35.2% in adults (n=38; 74% eccentric LVH; 26% concentric LVH), and 12.5% (n=7) in children, all of which were eccentric LVH. Prevalence of concentric remodelling was 16.7% (n=18) in adults and 3.6% (n=2) in children. Hypertension prevalence was 38.9% (n=42) for adults and 53.6% (n=30) for children. LVH was present in 15.4% of normotensive children and 40.9% of normotensive adults. Multivariate logistic regression with age, BMI, hypertension and diabetes status, previous heart disease, tobacco and alcohol use showed only current tobacco use (OR 10.60 [1.72-65.25] p=0.01) increased the odds of concentric LVH in adults. Conclusions: Approximately one third of adults and one in ten children had LVH, with eccentric LVH the predominant type of remodelling. Hypertension prevalence in this population was also high. This preliminary analysis supports public health efforts for tobacco cessation to impact overall cardiovascular risk.