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Multivariate Analysis of Left Ventricular Mass Determinants in Adults: Different Patterns in Men and Women
Richard S. Meltzer1, Diana Rinkevich, Shimon A. Reisner
1Cardiology, Box 679, University of Rochester Medical Center, Rochester, NY 14642.
Insights
Left ventricular mass (LVM) is linked to mortality. This study found stroke volume (SV) measured by echocardiography is a significant predictor of LVM, more so than systolic blood pressure (SBP) in women.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Echocardiographic left ventricular mass (LVM) is a critical predictor of cardiovascular outcomes.
- Established determinants of LVM include blood pressure (BP), weight (WT), and age.
- The role of stroke volume (SV) in LVM variability remains less understood.
Purpose of the Study:
- To investigate the correlation between Doppler echocardiographic stroke volume (SV) and left ventricular mass (LVM).
- To compare the predictive power of SV against systolic blood pressure (SBP) for LVM.
- To identify key determinants of LVM in men and women.
Main Methods:
- Echocardiography was used to determine LVM and SV in 213 patients.
- Cuff blood pressure (BP) measurements, including SBP, were recorded.
- Multiple regression analysis was employed to assess the relationships between LVM and predictor variables (WT, SV, SBP, AGE).
Main Results:
- Weight (WT) and stroke volume (SV) were significant determinants of LVM in both sexes.
- Systolic blood pressure (SBP) was a significant determinant in women, while age was significant in men.
- SV demonstrated a stronger correlation with LVM than SBP in both men and women.
Conclusions:
- Doppler echocardiographic SV is a novel determinant of LVM, with a stronger association than SBP.
- Weight remains the primary determinant of LVM.
- Distinct patterns of LVM determinants exist between men and women.
Abstract:
Echocardiographic left ventricular mass (LVM) estimates are strong predictors of subsequent mortality and cardiovascular events. It is known that blood pressure (BP), weight (WT), and age are significantly correlated with LVM. We hypothesized that stroke volume (SV) measured by Doppler echocardiography would also be correlated with LVM. Two hundred and thirteen patients referred for routine echocardiography had determination of LVM, cuff BP, and Doppler SV. Those with localized LV disease, valvular disease, or cor pulmonale were excluded. In both men and women, systolic BP (SBP) was more closely correlated with LVM than was diastolic blood pressure or mean arterial pressure, and SV was more closely correlated with LVM than cardiac output or cardiac index. Stepwise regression, followed by multiple regression showed that four variables (WT, SV, SBP, and AGE) explained 32.3% of the variability in LVM in men and 48.5% of the variability in LVM in women. WT and SV were significant determinants of LVM in both men and women. Age was also significant in men and SBP was also significant in women. For both men and women, SV was more significantly correlated with LVM than was SBP. The changes in LVM associated with 1 SD increments of SV and SBP, respectively, were 8 and 5 g for men and 13 and 11 g for women. We conclude that men and women have different patterns of variables influencing LVM. Doppler echocardiographic SV is a newly described determinant of LVM that has a greater correlation with LVM than does SBP. This study reemphasizes the importance of WT as the major determinant of LVM. (ECHOCARDIOGRAPHY, Volume 13, January 1996)