Abstract
BackgroundLeft ventricular hypertrophy is influenced by both hemodynamic and non-hemodynamic factors. Ambulatory blood pressure is correlated with left ventricular hypertrophy. We established the influences of hemodynamic and non-hemodynamic factors, including ambulatory blood pressure, on variation in left ventricular mass in healthy Korean adults.MethodWe included 172 subjects (male = 71, female = 101), with normal body mass index and blood pressure, in an analysis of data from the Yangpyung and Yeoju cohort studies and a tertiary cardiovascular center. Left ventricular mass was calculated using the equation: [1.04 × (IVSd + LVDd + PWTd) 3-(LDVs3)] × 0.8 + 0.6. Stroke volume was calculated (mL/beat) using Teichholz’s formula. Stroke work (SW in gram-meters/beat [g-m/beat]) was computed as ambulatory systolic BP × stroke volume × 0.0144.ResultsStroke work was the most important determinant associated with left ventricular mass (adjusted R2 = 0.442, p < 0.001), independent of height2.7 and sex. In a regression model including stroke work, height,2.7 and sex, the left ventricular mass was predicted by the equation: 43.11 + 0.61 × SW (g-m/beat) + 9.21 × height2.7-13.99 × sex (male = 1, female = 2) (constant = 43.11 ± 25.88, adjusted R2 = 0.532, p < 0.001).ConclusionWe examined ambulatory blood pressure, as in previous studies, and identified stroke work, height2.7, and sex as important determinants of left ventricular mass in Korean adults of normal weight and normal blood pressure. Ambulatory blood pressure is superior to clinical blood pressure for determining stroke work and predicted left ventricular mass.
Highlights
Left ventricular hypertrophy is influenced by both hemodynamic and non-hemodynamic factors
* Correspondence: jhs2003@hanyang.ac.kr 2Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, 04763 Seongdong-gu, Seoul, South Korea Full list of author information is available at the end of the article inappropriately high left ventricular mass (iLVM) is related to worse CV mortality than appropriate Left ventricular (LV) mass regardless of the presence of Left ventricular hypertrophy (LVH) [2]. iLVM may be explained by several mechanisms, including the presence of a higher central blood pressure (BP) load, which cannot be explained by brachial BP derived resting stroke work [3], imbalance between growth-promoting factors and growth inhibitory factors [4,5,6], and BP variability [7]
In a comparison of general characteristics between male and female subjects, primary echocardiographic measurements, stroke volume (SV), Stroke work (SW), and LV mass were higher in male subjects
Summary
Left ventricular hypertrophy is influenced by both hemodynamic and non-hemodynamic factors. Ambulatory blood pressure is correlated with left ventricular hypertrophy. We established the influences of hemodynamic and non-hemodynamic factors, including ambulatory blood pressure, on variation in left ventricular mass in healthy Korean adults. Left ventricular (LV) mass is influenced by hemodynamic factors, such as high blood pressure (BP) and stroke work, as well as non-hemodynamic factors [2]. ILVM may be explained by several mechanisms, including the presence of a higher central BP load, which cannot be explained by brachial BP derived resting stroke work [3], imbalance between growth-promoting factors and growth inhibitory factors [4,5,6], and BP variability [7]. The presence of hidden higher BP load outside of the clinic setting or during sleep that cannot be explained by clinical BP deserves attention
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