Association Of Left Ventricular Mass Research Articles

ASSOCIATION OF LEFT VENTRICULAR MASS INDEX WITH ALL-CAUSE MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS

Objective: Although the association of left ventricular mass (LVM) with outcome is well established in dialysis patients, the importance of this association in pre-dialysis chronic kidney disease (CKD) populations is not well documented. Aim of the study was to examine the association of LVM index with all-cause mortality in CKD patients. Design and method: Our study population consisted of 126 patients with CKD stages 3–4, referred for evaluation at the Hypertension Unit of our department. The patients underwent office blood pressure measurements and echocardiographic measurements. LVM was estimated using Devereux’s formula according to the Penn Convention Protocol. LVM index was defined as LVM divided by the body surface area. Cox regression analysis was used to evaluate the association between LVM index and all-cause mortality. Results: After a median follow-up of 3 years, 11 cardiovascular and 16 non-cardiovascular deaths occurred. The study population consisted of 95 men (75%). Mean age was 70 years, mean office BP was 143/76 mmHg. The multivariate Cox regression analyses revealed that LVM index was independently associated with all-cause mortality (HR: 1.011, 95%CI 1.000–1.023, p = 0.049) after adjustment for age, sex, history of diabetes mellitus and hyperlipidemia, smoking, antihypertensive treatment and mean office blood pressure values. Conclusions: Left ventricular mass index is an independent predictor of all-cause mortality in hypertensive patients with CKD.

Abstract 11052: The Association Between Left Ventricular Mass and Coronary Artery Calcium Score in Retired National Football League Players

Introduction: Literature suggests that increased left ventricular mass (LVM) is a predictor of coronary heart disease and mortality in the general population, and that increased LVM is associated with higher CAC. However, the association between LVM and subclinical atherosclerosis as indicated by absolute CAC has not been widely explored in retired elite athletes, who may have had or still have increased LVM as a result of exercise adaptation. Thus, we sought to investigate this association in a cohort of retired National Football League (NFL) players. Methods: This cross-sectional study included 632 retired NFL players aged 40 and older (mean age 56.4 ± 9.7 yrs; 51.3% Black) that participated in NFL Player Care Foundation health screenings. Two-dimensional echocardiogram was used to determine LVM according to American Society of Echocardiology guidelines and indexed to height to obtain left ventricular mass index (LVMI, g/m 2.7 ). LVH was considered as LVMI &gt 49.2 g/m 2.7 . Multi-variable logistic regression models were utilized to determine the association of LVM with the highest quintile of CAC (CAC = 264-6239) after adjusting for traditional cardiometabolic risk factors. Results: The mean LVM of study participants was 220.8 ± 56.6 g and the prevalence of LVH 16.9%. LVM was highest in the 2 nd quintile of CAC, with LVM in the highest quintile of CAC significantly lower than that of the first and second quintiles and not significantly different from that of the 3 rd or 4 th quintiles. Multi-variable logistic regression models revealed that increasing LVM was associated with decreased odds for the highest quintile of CAC (odds ratio [OR]: 0.99, 95% confidence interval [CI] 0.99 - 1.00, p = 0.0486), with no such association for LVH (OR: 0.72, 95% CI 0.37-1.41, p = 0.3429). Conclusion: Odds for increased atherosclerotic cardiovascular disease risk, as indicated by the highest quintile of CAC, are decreased by augmented LVM within physiological range in this cohort of retired NFL players, possibly reflective of a potential protective effect of high lifetime exercise dose. These results suggest that there may be lingering or carryover effect of early life cardiovascular fitness, even in middle-aged retired athletes.

Abstract 16191: Association of Left Ventricular Mass Progression With Heart Failure Events: Implications for Understanding the Hispanic Paradox

Introduction: Hispanics have been described as paradoxically having a higher prevalence of cardiovascular (CV) risk factors (RFs) but lower CV mortality compared to non-Hispanic Whites (NHW). The association of left ventricular mass (LVM) change with heart failure (HF) has not been well studied and variability across race-ethnic groups is unknown. Methods: MESA participants with LVM measurements by cardiac MRI at baseline and exam 5 (10-year interval) were included and followed for HF events after exam 5. LVM was calculated as the percentage of the predicted value based on height, weight and sex in a healthy population. LVM absolute (exam 5 - baseline) and relative change were compared across race-ethnic groups (Hispanics, non-Hispanic blacks [NHB], NHW, Chinese). HF RFs included hypertension, diabetes and obesity. The association between LVM change with incident HF events was evaluated using age-gender adjusted Cox proportional hazard models. Results: Among 2,981 participants (mean age 60 years, 53% female, 20% Hispanics, 42% NHW, 25% NHB, 13% Chinese) LVM at both exams was higher in NHB followed by Hispanics, whereas NHW and Chinese had the lowest LVM (Table) . Over 10-years, NHB had the highest LVM relative change (+4.4%) and Hispanics had the lowest (+1.7%). HF RFs were more prevalent in NHB and Hispanics compared to the other groups (p<0.01). After a mean follow-up time from exam 5 of 6.4 years, an 18% increase in HF risk was seen per 5-unit increase in LVM in the total population. In race-ethnicity stratified analyses, this association was seen only in NHB (22% increase in HF risk per 5-unit LVM increase, p=0.01), and Hispanics (34% increase in HF risk per 5-unit LVM increase, p<0.01). Conclusions: Hispanics and NHBs had a high burden of HF risk factors and higher baseline LVM relative to other groups. Hispanics paradoxically exhibited the lowest whereas NHB had the highest degree of LVM change over time, and yet both groups had similarly increased HF risk associated with LVM change.

Abstract 15034: Exposure to Secondhand Smoke is Associated With Increased Left Ventricular Mass

Background: Exposure to secondhand smoke (SHS), or passive smoking, has been associated with chronic hypertension. However, little is known about the relationship between SHS and left ventricular (LV) hypertrophy, the most common complication of hypertension and a manifestation of cardiac end-organ damage. Hypothesis: SHS exposure is independently associated with LV mass. Methods: This analysis included 4,982 non-smoker participants (age 60.8±13.6 years, 57.8% women, 77.7% whites) from the Third National Health and Nutrition Examination (NHANES-III). Non-smoking was defined by self-report and serum cotinine ≤ 10 ng/dL, a biomarker for tobacco exposure. SHS was defined as serum cotinine level >1 ng/dL. LV mass was estimated using an electrocardiographic model developed and applied in NHANES-III then validated in the Cardiovascular Health Study. Multivariable linear regression was used to examine the cross-sectional association between SHS exposure (vs. no exposure) with estimated LV mass. In similar models, we also examined the associations of LV mass across quartiles of serum cotinine (reference group, 1 st quartile) and in subgroups stratified by race, sex, and hypertension status. Results: About 9.8% (n=489) of the participants were exposed to SHS. Exposure to SHS was associated with an estimated 2.9 gram increase in LV mass, with a dose-response relationship between higher serum cotinine and LV mass ( Table ). These results were consistent in men and women (interaction p-value= 0.31), whites and non-whites (interaction p-value= 0.21), and those with and without hypertension (interaction p-value= 0.88) Conclusion: In a racially diverse sample of non-smokers, SHS is associated with increased LV mass with a dose-response relationship between level of exposure and LV mass. These findings underscore the harmful effect of passive smoking on the cardiovascular system and highlight the need for more restrictions on smoking in public areas.

Left ventricular mass and incident out-of-office hypertension in a general population.

Findings regarding the association of left ventricular mass (LVM) and new-onset hypertension are based on blood pressure measured in the office. We sought to assess the value of LVM in predicting in-office and out-of-office incident hypertension in members of the general population enrolled in the Pressioni Monitorate E Loro Associazioni study. The study included participants with normal office (n = 792), home (n = 714) and 24-h (n = 825) ambulatory blood pressure (ABP) at baseline evaluation who had a readable echocardiogram at entry and at the end of follow-up. Each normotensive group was divided into quartiles of LVM indexed (LVMI) to height. Over a follow-up of 148 months cumulative incidence of new office, home and 24-h ABP hypertension were 35.9, 30.7 and 36.1%, respectively. In fully adjusted models (including age, sex, BMI change during follow-up, baseline serum glucose, creatinine, total cholesterol office, home and 24-h SBP and DBP). higher LVMI values (i.e. the highest vs. the lowest quartile) were independently associated with an increased risk of home [odds ratio (OR) = 2.14, 95% confidence interval (CI) 1.21-3.77, P = 0.008] and 24-h ABP hypertension (OR = 1.70, 95% CI 1.05-2.76, P = 0.03). This was not the case for new-onset office hypertension (OR = 1.61, 95% CI 0.94-2.74, P = 0.07). Our study provides the first evidence that in normotensive individuals the magnitude of LVMI is independently associated with the risk of incident out-of-office hypertension.

P1682Triglycerides are related to left ventricular mass in hypertensive patients, independently of other cardiometabolic risk factors: The effect of gender

Abstract Introduction LDL cholesterol (LDL-C) is a strong cardiovascular risk factor and the main goal of treatment for both primary and secondary prevention. However, triglycerides (TGs) also convey a significant prognostic role. Left ventricular hypertrophy (LVH) increases cardiovascular risk in hypertensive patients. The purpose of the present study was to investigate the association of left ventricular mass (LVM) with TGs in never treated hypertensive patients. Methods We studied 760 never treated, non diabetic, hypertensive patients. Participants were subjected to transthoracic echocardiography and LVM was calculated according to the Devereux formula, indexed to body surface area (LVMI). Lipid variables including LDL-C, TGs, HDL-C, apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) were measured in all patients. Results In multivariate regression analysis, LVMI was independently associated with TGs after adjustment for age, gender, smoking, SBP, glucose, LDL-C and ApoB/ApoA1 ratio (b=0.07, p=0.04). Gender-stratified analysis indicated that TGs were related to LVMI in men (b=0.15, p=0.001) but not in women (p=NS). In addition, TGs were associated with LVH in men increasing the odds by 7% to present LVMI over 115 g/m2 after controlling for age, smoking, SBP and glucose (OR: 1.07 per 10 mg/dl increase in TGs, 95% CI: 1.02–1.14, p=0.01). Conclusion TGs are strong determinants of LVMI in hypertensive patients, independently of other cardiometabolic risk factors, including LDL-C. The gender discrepancy may suggest a gender-specific effect of TGs on LV structure. Future studies need to clarify whether lowering TGs may induce regression of LVH, thus improving cardiovascular risk in hypertensive patients.

Abstract P261: Associations of Left Ventricular Mass, Total Body Weight, and Fat-Free Mass With Body Mass Index: The Framingham Heart Study

Introduction: Increased left ventricular mass (LVM) predicts excess cardiovascular morbidity and mortality. LVM is often indexed to height (HT) or body surface area (BSA). HT-indexation ignores weight and thus obesity. The relationship of indexed LVM with weight, obesity, and adiposity is unclear. We investigated the association of LVM with total-body mass (TBM, i.e. weight) and fat-free mass (FFM), hypothesizing that LVM scales better to FFM than TBM. Methods: From the 1794 members of Framingham Offspring cohort who underwent cardiac magnetic resonance (CMR), we identified 845 (aged 65±9y) without any history of hypertension, myocardial infarction, heart failure, or CMR wall-motion abnormality. LVM was measured from cine bSSFP images and indexed to HT, BSA, TBM and FFM (by DEXA). Participants were stratified by sex and body mass index (BMI) category (NL=BMI 18.5 - 24.9; OW=25.0 - 29.9; OB=30.0+ kg/m 2 ). We used sex-specific ANCOVA to test for linear trend across BMI categories, and determined sex-specific Pearson correlation coefficients of LVM with BMI; both sets of analyses were adjusted for age and systolic blood pressure. Data are summarized as mean ± SD. Results: The Table shows that LVM and LVM/HT increase with greater BMI-category in both sexes. LVM/BSA was similar across BMI-categories, while LVM/TBM decreased. There was no linear trend across BMI-categories for LVM/FFM in either sex. On a continuous basis, LVM and LVM/HT were positively correlated with BMI in both sexes (r=0.20 to 0.35, p<0.001 for all); LVM/BSA was weakly inversely correlated with BMI in women only (r=-0.14, p=0.001) but not men (r=-0.08, p=0.18); LVM/TBM was inversely correlated with BMI (M: r=-0.39, W: r=-0.54; p<0.0001 both); LVM/FFM was not correlated with BMI in either sex (M: r=-0.05, p=0.38, W: r=0.08, p=0.055). Conclusion: LVM as a proportion of TBM (weight) actually decreases with greater BMI, while LVM/FFM is not associated with BMI. Whether LVM is better scaled to FFM vs HT, BSA or TBM for risk stratification purposes remains to be determined.

Genetic association of left ventricular mass assessed by M-mode and two-dimensional echocardiography.

Left ventricular mass offers prognostic information for assessing cardiovascular disease risk. M-mode and two-dimensional (2D) echocardiographically-derived left ventricular mass values have shown high accuracy and reproducibility; however, no studies to date have compared left ventricular mass genetic association findings on the basis of both the methods. The aim of this study was to compare associations of single-nucleotide polymorphisms (SNPs) from genome-wide association study analyses of left ventricular mass using both methods in the same cohort. Left ventricular mass was determined using 2D and M-mode echocardiography in 711 patients (390 women); SNP genotype data were obtained using the Genome-wide Human SNP Array 6.0. Genome-wide association study analyses were performed to obtain panels of SNPs associated with left ventricular mass and left ventricular mass index. The unindexed left ventricular mass showed excellent agreement [M-mode: 170 ± 47 vs. 2D: 178 ± 56 g; intraclass correlation coefficient 0.929 (95% confidence interval 0.932, 0.909)]. The presence of left ventricular hypertrophy based on M-mode and 2D-derived left ventricular mass index values showed moderate agreement (kappa = 0.49). Eleven SNPs showed suggestive association with at least two of the four left ventricular mass traits, with one SNP in CDH13 common to all four derived traits. M-mode and 2D echocardiography left ventricular mass measurements in the same cohort identified suggestive genetic associations, both shared and unshared, suggesting common left ventricular mass biology underlying the two measures of left ventricular mass. The combined use of M-mode and 2D echo is a novel approach that may increase the yield of genetic association with left ventricular mass.

Relationship of left ventricular mass to coronary atherosclerosis and myocardial ischaemia: the CORE320 multicenter study.

The aim of this study was to investigate the association of left ventricular mass (LVM) with coronary atherosclerosis and myocardial infarction (MI). Patients (n = 338) underwent 320 × 0.5 mm detector row coronary computed tomography (CT) angiography, invasive coronary angiography (ICA), and single-photon emission CT (SPECT) myocardial perfusion imaging. Quantitative coronary atheroma volume was obtained from the CT images for the entire coronary tree (19-segment model) with an arterial contour detection algorithm. Normalized total atheroma volume (NormTAV) was analysed to reflect quantitative total atheroma volume. LVM was measured on myocardial CT images and indexed to height to the power of 2.7 (LVMi). Patients with obstructive coronary artery disease (CAD) were defined as those with ≥50% diameter stenosis by quantitative ICA. Abnormal perfusion defect was defined as ≥1 abnormal myocardial segment by SPECT. The association of LVMi with coronary atherosclerosis and myocardial perfusion defect on SPECT at the patient level was determined with uni- and multivariable linear and logistic regression analyses. Obstructive CAD was present in 60.0% of enrolled patients. LVMi was independently associated with abnormal summed rest score [SRS; odds ratio (OR), 1.07; 95% confidence interval (CI), 1.03-1.09] and summed stress score (OR, 1.04; 95% CI, 1.01-1.07). An increase in LVMi was also independently associated with that in NormTAV (coefficient, 10.44; 95% CI, 1.50-19.39) and SRS ≥1 (OR, 1.05; 95% CI, 1.01-1.10), even after adjusting for cardiovascular risk factors in patients without previous MI. LVM was independently associated with the presence of coronary artery atherosclerosis and MI.

Bilirubin Level is Associated with Left Ventricular Hypertrophy Independent of Blood Pressure in Previously Untreated Hypertensive Patients.

Background and ObjectivesLeft ventricular hypertrophy (LVH), a sign of subclinical cardiovascular disease, is an important predictor of cardiovascular morbidity and mortality. The aim of our study was to determine the association of left ventricular mass (LVM) with possible causative anthropometric and biochemical parameters as well as carotid intima-media thickness (CIMT) and brachial flow-mediated dilation (FMD) as surrogates of atherosclerosis and endothelial dysfunction, respectively, in previously untreated hypertensive patients.Subjects and MethodsOur study included 114 consecutive previously untreated hypertensive patients who underwent echocardiography and ultrasonography to evaluate their vascular status and function via brachial artery CIMT and FMD.ResultsAmong all study parameters, age, systolic blood pressure (BP), diastolic BP, pulse pressure, plasma glucose, uric acid, total bilirubin, direct bilirubin, hemoglobin, and CIMT were positively correlated with the LVM index. Multiple logistic regression analysis revealed that office systolic BP, age, male gender, and total bilirubin were independent predictors of LVH.ConclusionBilirubin seems to be related to LVM and LVH. The positive association of bilirubin with these parameters is novel and requires further research.

Relation of Left Ventricular Mass at Age 23 to 35 Years to Global Left Ventricular Systolic Function 20 Years Later (from the Coronary Artery Risk Development in Young Adults Study)

Left ventricular (LV) mass and the LV ejection fraction (LVEF) are major independent predictors of future cardiovascular disease. The association of LV mass with the future LVEF in younger populations has not been studied. The aim of this study was to investigate the relation of LV mass index (LVMI) at ages 23 to 35 years to LV function after 20 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) study. CARDIA is a longitudinal study that enrolled young adults in 1985 and 1986. In this study, participants with echocardiographic examinations at years 5 and 25 were included. LVMI and the LVEF were assessed using M-mode echocardiography at year 5 and using M-mode and 2-dimensional imaging at year 25. Statistical analytic models assessed the correlation between LVMI and LV functional parameters cross-sectionally and longitudinally. A total of 2,339 participants were included. The mean LVEF at year 25 was 62%. Although there was no cross-sectional correlation between LVMI and the LVEF at year 5, there was a small but statistically significant negative correlation between LVMI at year 5 and the LVEF 20 years later (r = -0.10, p <0.0001); this inverse association persisted for LVMI in the multivariate model. High LVMI was an independent predictor of systolic dysfunction (LVEF <50%) 20 years later (odds ratio 1.46, p = 0.0018). In conclusion, LVMI in young adulthood in association with chronic risk exposure affects systolic function in middle age; the antecedents of heart failure may occur at younger ages than previously thought.

Association of left ventricular mass with all-cause mortality, myocardial infarction and stroke.

BackgroundOur aim was to assess the association of left ventricular mass with mortality and nonfatal cardiovascular events.Methodology/Principal FindingsLeft ventricular mass was measured by echocardiography in 40138 adult patients (mean age 61.1±16.4 years, 52.5% male). The primary endpoint was all-cause mortality. Secondary endpoints included nonfatal myocardial infarction and nonfatal stroke. During a mean follow-up period of 5.6±3.9 years, 9181 patients died, 901 patients had a nonfatal myocardial infarction, and 2139 patients had a nonfatal stroke. Cumulative 10-year mortality was 26.8%, 31.9%, 37.4% and 46.4% in patients with normal, mildly, moderately and severely increased left ventricular mass, respectively (p<0.001). Ten-year rates of nonfatal myocardial infarction and stroke ranged from 3.2% and 6.7% in patients with normal left ventricular mass to 5.3% and 12.7% in those with severe increase in left ventricular mass, respectively. After multivariate adjustment, left ventricular mass remained an independent predictor of all-cause mortality (hazard ratio [HR] per 100 g increase 1.21, 95% confidence interval [CI] 1.14–1–27, p<0.001 in women, and HR 1.09, 95% CI 1.04–1–13, p<0.001 in men), myocardial infarction (HR 1.60, 95% CI 1.31–1.94, p<0.001 in women and HR 1.15, 95% CI 1.02–1.29, p = 0.019 in men) and stroke (HR 1.26, 95% CI 1.13–1.40, p<0.001 in women and HR 1.19, 95% CI 1.09–1.30, p<0.001 in men).Conclusions/SignificanceLeft ventricular mass has a graded and independent association with all-cause mortality, myocardial infarction and stroke.

Association of left ventricular mass with the AGTR1 A1166C polymorphism

The A1166C polymorphism is located within the microRNA-155 binding site of the human angiotensin II (Ang II) type-1 receptor (AGTR1) gene. The C allele interferes with the base-pairing complementariness between AGTR1 mRNA and microRNA-155 and thereby increases AGTR1 protein expression in vitro. We hypothesized that left ventricular (LV) mass is associated with the AGTR1 A1166C polymorphism. Among 708 individuals (mean age, 49.4 years; 51.8% women) randomly recruited in a white European population, we measured LV structure by two-dimensional guided M-mode echocardiography, the AGTR1 A1166C polymorphism and the 24-h urinary aldosterone. We applied a mixed model to assess phenotype-genotype associations while adjusting for covariables and accounting for relatedness. The AA (49.1%), AC (42.8%), and CC (8.1%) genotypes were in Hardy-Weinberg equilibrium. Using a recessive model, CC homozygotes compared to A-allele carriers showed significant increases (P < 0.021) in LV mass index (+5.78 ± 2.25 g/m(2)), mean wall thickness (MWT) (+0.48 ± 0.15 mm), interventricular septum (IVS) (+0.60 ± 0.18 mm) and posterior wall thickness (PWT) (+0.34 ± 0.15 mm), but lower 24-h urinary aldosterone excretion (geometric mean, 22.4 vs. 19.0 nmol; P = 0.050). Sensitivity analyses in 552 participants untreated for hypertension were confirmatory. LV mass index is associated with the AGTR1 A1166C polymorphism. Further research should clarify to what extent this association might be mediated via different expression of AGTR1 as modulated by microRNA-155.

Association of echocardiographic left ventricular structure with the ACE D/I polymorphism: a meta-analysis

: In a previous meta-analysis, we derived pooled estimates for the association of left ventricular mass (LVM) and hypertrophy (LVH), as diagnosed by electrocardiography or echocardiography, with the ACE D/I polymorphism. We updated this meta-analysis until May 2009 only considering echocardiographic phenotypes. : We computed pooled estimates from a random-effects model. : Across 38 studies, both DD homozygotes (n = 2440) and DI heterozygotes ( n = 4310) had higher (p ≤ 0.002) LVM or LVM index than II homozygotes (n = 2229). Across 21 studies with available data, this was due to increased mean wall thickness (MWT) with no difference in left ventricular internal diameter (LVID). Standardised differences (DD versus II) were 0.39 (p < 0.001) for LVM, 0.34 (p = 0.009) for MWT, and 0.066 (p = 0.26) for LVID. Across 16 studies (4894 participants), the pooled odds ratios of LVH (versus II homozygotes) were 1.11 (p = 0.29) and 1.02 (p = 0.88) for the DD and DI genotypes, respectively. Sensitivity analyses were confirmatory. : Our meta-analysis supports the hypothesis that the enhanced ACE activity associated with the D allele is associated with higher LV mass. Smaller sample size might explain the lack of significant association with LVH.

ASSOCIATION OF ECHOCARDIOGRAPHIC LEFT VENTRICULAR STRUCTURE WITH THE ACE D/I POLYMORPHISM: A META-ANALYSIS: PP.22.364

Introduction: In a meta-analysis published in 2000, we derived pooled estimates for the association of left ventricular mass (LVM) and hypertrophy (LVH), as diagnosed by electrocardiography or echocardiography, with the deletion/insertion polymorphism in the angiotensin-converting enzyme gene (ACE D/I). Design: We updated the meta-analysis until May 2009, but we only considered echocardiographically phenotypes. Methods: We used random effects models to compute pooled estimates. Results: Of 831 screened studies, we reviewed 43 studies (10320 participants, 17.5% Asians, 82.4% Whites, 0.1%Blacks). Across 38 studies, both DD homozygotes (n = 2440) and DI heterozygotes (n = 4310) had higher (p ≤ 0.002) LVM or LVM index than II homozygotes (n = 2229). Across 21 studies with available data, this was due to increased mean wall thickness (MWT) with no difference in left ventricular internal diameter (LVID). Standardised differences (DD vs II) were 0.39 (95% confidence interval 0.20 to 0.59, p < 0.001) for LVM, 0.34 (0.085 to 0.59, p = 0.009) for MWT, and 0.066 (–0.049 to 0.18; p = 0.26) for LVID. Across 16 studies (4894 participants), the pooled odds ratios of LVH (vs II homozygotes) were 1.11 (0.91 to 1.36, p = 0.29) and 1.02 (CI 0.75 to 1.39, p = 0.88) for the DD and DI genotypes, respectively. For LVM, there was a deficit of small studies with null results, but for LVH we did not find publication bias. Sensitivity analyses were confirmatory. Conclusions: Our meta-analysis supports the hypothesis that the enhanced ACE activity associated with the D allele is associated with higher LV mass. Smaller sample size might explain the lack of significant association with LVH.

Abstract 2828: The Relationship Of Left Ventricular Structure And Function With Subclinical Measures Of Atherosclerosis: The Multi-ethnic Study Of Atherosclerosis

Background: Left ventricular (LV) structure and function are important independent predictors of cardiovascular events, but the relationship of these parameters to indices of subclinical atherosclerosis has not been evaluated in an asymptomatic population. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) includes 6,814 men and women, aged 45– 85 years; white, African-American, Hispanics, and Chinese. LV parameters were measured by MRI. Measures of subclinical atherosclerosis included carotid intima-media thickness (IMT) determined by high-resolution B-mode ultrasonography and coronary artery calcification (CAC) defined as phantom-adjusted Agatston calcium score from brightness adjusted CT images. Results: In univariable analyses, LV mass index, LV ejection fraction (LVEF), and LV end-diastolic volume (EDV) were significantly associated with both the presence and the extent of CAC as well as with carotid IMT (Table ). But after adjustment for traditional risk factors, the magnitudes of the associations decreased considerably. Although the relationship of LV mass with carotid IMT and CAC remained statistically significant, the associations of LVEF and EDV with CAC and IMT were not significant in multivariable analyses. LV ejection fraction and LV end-diastolic volume were also associated with CAC and IMT in univariable analyses, but these associations were not significant in multivariable analyses. Although there was no significant effect modification by ethnicity, the association of LV mass with CAC was stronger in African Americans and Hispanics, compared to Caucasians and Chinese Americans. Conclusions: Subclinical atherosclerosis is associated with increased LV mass and decreased LV function. However, these associations may be in part due to the relationship of traditional risk factors for atherosclerosis with LV structure and function, independent of an atherosclerotic process.

The association of left ventricular mass with blood pressure, cigarette smoking and alcohol consumption; data from the LARGE heart study

Background Left ventricular mass is a risk factor for cardiovascular morbidity and mortality. Although factors associated with elevated left ventricular mass have been sought and studied extensively in elderly and in diseased subjects, few studies have examined the young and healthy. The aim of this study was to examine the possible influence of lifestyle on left ventricular mass in a large group of young men. Methods Left ventricular mass was assessed using cardiovascular magnetic resonance in 541 healthy Caucasian male army recruits. Anthropometric, lifestyle and blood pressure data were collected. Results Mean unadjusted left ventricular mass and left ventricular mass indexed to body surface area were 163.8 ± 24.9 g and 86.6 ± 10.2 g m − 2 respectively. In univariate analysis, age, height, weight, alcohol consumption, systolic blood pressure, diastolic blood pressure and indices of physical activity were positively associated with unadjusted left ventricular mass (all P < 0.02). By contrast, smoking was associated with lower mean left ventricular mass; never smoked 167.5 ± 25.8 g vs ex-smokers 159.1 ± 25.2 g vs current smokers 161.0 ± 23.1 g ( P = 0.007). Multivariate analysis revealed weight, systolic blood pressure, smoking status and indices of physical activity to be independent predictors of left ventricular mass. Conclusions Our data confirm an association of age, body weight, height, physical activity, diastolic and systolic blood pressure with left ventricular mass. In addition, unexpectedly, we have found smoking is associated with lower left ventricular mass in a large sample of young healthy men. Although the latter association may result from confounding effects, such an interesting observation deserves further investigation.

Relation of Increase in Adiposity to Increase in Left Ventricular Mass from Childhood to Young Adulthood

This study evaluated the influence of adiposity on the progression of left ventricular (LV) mass from childhood to adulthood and the relation of LV mass to insulin resistance in young adulthood. One hundred thirty-two healthy children recruited into a longitudinal study at a mean age of 13 years and reevaluated at 27 years, at which time insulin resistance studies were also performed, were studied. Echocardiographic assessment of LV mass was made and indexed for height. Body mass index (BMI) at 13 years was highly correlated with BMI at 27 years, as was LV mass index at 13 and 27 years. The cross-sectional correlation of LV mass index and BMI at 13 years (r = 0.38, p < 0.0001) had strengthened considerably by 27 years (r = 0.55, p < 0.0001). A BMI increase > or = 5.5 kg/m2 from 13 to 27 years was associated with a significantly greater increase in the LV mass index (p < 0.0001) than a BMI change < 5.5 kg/m2, and this relation was similar in children who were thin and heavy at baseline. In young adulthood, the relation of LV mass index to lean mass was weaker than that of LV mass index to fat mass. The association of LV mass with insulin resistance was dependent on adiposity. In conclusion, adiposity and LV mass are related in childhood, and this association tracks and becomes stronger in young adulthood. Moreover, the increase in LV mass from childhood to young adulthood is related to the degree of increase in BMI, independent of BMI at 13 years, suggesting that an excessive increase in LV mass could be limited by controlling gain in body fat during adolescence.

1136 The heart in the city: ability of hand-held echocardiography to detect independent association of left ventricular mass and aortic root size

1136 The heart in the city: ability of hand-held echocardiography to detect independent association of left ventricular mass and aortic root size

Association of left ventricular mass and stress induced left ventricular cavity dilation in patients with normal myocardial perfusion scans

Association of left ventricular mass and stress induced left ventricular cavity dilation in patients with normal myocardial perfusion scans