Changes in Left Ventricular Mass and Geometry in the Older Adults: Role of Body Mass and Central Obesity

Abstract

Left ventricular (LV) hypertrophy is an independent risk factor for cardiovascular outcomes. There are limited data about modifiable factors associated with progression of LV hypertrophy in older adults. Our objective is to describe the changes in LV mass and geometry over time in a predominantly older multiethnic cohort and to identify possible predictors of changes over time. We analyzed data from participants in the Northern Manhattan Study who underwent serial echocardiographic studies, comparing the baseline and the most recent echocardiograms. We recorded changes in LV mass and geometry and correlated them with baseline characteristics using linear regression models. There were 826 participants (mean age, 64.2±8.0years) included in the analysis (time between measurements, 8.5±2.7years). Overall, LV mass index increased from 45.0±12.7 to 50.3±14.6g/m2.7 (P<.001). There were 548 participants (66.3%) with LV mass increase; 258 individuals (31.2%) showed worsening LV geometry. Multivariable analysis showed that change in LV mass index was independently associated with baseline LV mass index (β estimate, -17.000 [standard error, 1.508]; P<.001), hypertension (2.094 [0.816], P=.011), body mass index (0.503 [0.088], P<.001), and waist-to-hip ratio (1.031 [0.385], P=.008). Both waist-to-hip ratio and waist-to-height ratio remained significantly associated with LV mass increase even after adjusting for body mass index (P=.008 and P=.036, respectively). Regardless of race/ethnicity, LV mass progressed over time in older adults. We also observed that worsening geometry was frequent. Assessment of central obesity in the older population is important because indicators of central obesity add prognostic value over body mass index for the risk of LV mass increase.