Determinants of Left Ventricular Geometric Alterations and Related Clinical and Metabolic Factors in a General Population

Abstract

Left ventricular (LV) remodeling has been shown to impart prognostic significance in previous studies. However, the underlying exact mechanisms involved and interactions between LV geometry alterations and age with other clinical and biochemical variables in general population have not been well established. A total of 406 consecutive subjects were enrolled in a health evaluation center-based population study (mean age, 51.5 ± 10.9 years; 42% women). Data including baseline characteristics, echocardiography, biochemistry and biomarkers were all collected and evaluated. Univariate and multivariate regression analysis was performed to test the relationship between relative wall thickness (RWT) and other variables. We also divided the subjects into older and younger groups, compared RWT between the two groups, and analyzed the distribution of LV geometry in these groups. The prevalence of diabetes and hypertension in our study population was relatively small (11.6% and 16.5%, respectively). The most common type of LV geometry in our study was normal (67.5%) and concentric remodeling (30.3%) compared with a relatively small proportion of concentric LV hypertrophy (1.5%) and eccentric hypertrophy (< 1%). Of all 406 subjects evaluated, age, uric acid, height, systolic blood pressure and serum insulin level were all independent factors associated with RWT in a multivariate regression model. In our study, we revealed that aging, together with baseline blood pressure and serum biochemistries, were associated with LV geometric alterations. These data suggest that the LV remodeling process actually involves dynamic and complex interactions with multiple metabolic factors in an unselected general population in Taiwan.