Predictors Affecting Left Ventricular Geometry in Non-Hypertensive,Healthy Subjects: Association of Concentric Remodelling With EarlyDiastolic Dysfunction

Abstract

Abstract The geometric patterns of remodelling are related to hemodynamic and traditional cardiovascular risk factors; however, the clinical significance of left ventricular (LV) concentric remodelling (CR) with a normal LV mass and small LV cavity in a general population is not known well. This study assessed the prevalence, predictors and function of LV CR in healthy subjects without hypertension. For cross-sectional analysis, 1049 subjects were enrolled and examined using conventional and tissue Doppler echocardiography. Parameters measured included diastolic function (septal e’, E/e’), LV mass index (LVMI) and relative wall thickness (RWT). All subjects were categorized into four LV geometric patterns by LVMI and RWT (Normal geometry (N), normal LVMI and RWT; CR, normal LVMI and high RWT; concentric hypertrophy (CH), increased LVMI and high RWT; eccentric hypertrophy (EH), increased LVMI and normal RWT). Logistic regression analysis (CR vs. normal) was adjusted for age, sex, and cardiovascular and metabolic risk factors. Subjects (mean age, 62.8 ± 12.8 years; 59% male) were distributed as follows: normal, 51%; CR, 27%; CH, 13%; and EH, 9%. The CR prevalence increased with age, and this group demonstrated a significantly lower e’ and higher E/e’ compared to the normal group. No sex differences were observed. Age, waist circumference and systolic blood pressure were independent predictors of CR. Concentric remodeling frequently exists in healthy subjects and is associated with impaired myocardial relaxation.