Left ventricular hypertrophy, aortic wall thickness, and lifetime predicted risk of cardiovascular disease:the Dallas

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Sachin Gupta1, Jarett D Berry, Colby R Ayers

  • 1Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

JACC. Cardiovascular Imaging
|June 15, 2010
PubMed

Insights

Individuals with low short-term coronary heart disease risk but high lifetime cardiovascular disease (CVD) risk show increased left ventricular (LV) hypertrophy and aortic wall thickness (AWT). This highlights subclinical abnormalities beyond coronary artery calcium in predicting future CVD risk.

Area of Science:

  • Cardiology
  • Cardiovascular Disease Research
  • Preventive Cardiology

Background:

  • Lifetime risk prediction stratifies individuals under 50 into low/high cardiovascular disease (CVD) risk groups.
  • High lifetime CVD risk is linked to subclinical atherosclerosis, but coronary artery calcium is not always detectable.
  • Alternative subclinical markers may indicate increased CVD risk in younger adults.

Purpose of the Study:

  • To investigate if individuals with low short-term coronary heart disease (CHD) risk but high lifetime CVD risk exhibit greater left ventricular (LV) hypertrophy and aortic wall thickness (AWT).
  • To compare subclinical cardiovascular abnormalities between low short-term/high lifetime risk and low short-term/low lifetime risk groups.

Main Methods:

  • Cardiac magnetic resonance imaging was used to assess 1,804 Dallas Heart Study participants aged 30-50 years.
  • Participants were stratified into low/low lifetime risk, low short-term/high lifetime risk, and high short-term risk groups.
  • LV hypertrophy and AWT were compared between low short-term risk groups with differing lifetime risks.

Main Results:

  • Individuals with low short-term/high lifetime CVD risk had significantly increased LV mass compared to those with low short-term/low lifetime risk (p < 0.001).
  • LV concentricity, wall thickness, and AWT were also significantly greater in the high lifetime risk group (p < 0.001).
  • These findings were consistent even in participants without detectable coronary artery calcium.

Conclusions:

  • A high lifetime predicted CVD risk is associated with concentric LV hypertrophy and increased AWT in individuals aged 30-50 with low short-term risk.
  • These subclinical changes indicate a higher cardiovascular risk profile.
  • Lifetime risk assessment identifies individuals needing closer monitoring for CVD, even with low immediate risk.
Abstract

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