Related Experiment Video
Updated: May 28, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Association of blood pressure and left ventricular mass with subclinical coronary atherosclerosis
Enver De Wei Loh1, Weiting Huang2, Rehena Sultana3
1Lee Kong Chian School of Medicine, Singapore.
Insights
Hypertension is the main risk factor for increased left ventricular mass and coronary artery calcium in healthy adults. Left ventricular hypertrophy modifies risk, but its significance without hypertension needs more research.
Area of Science:
- Cardiology
- Preventive Medicine
- Imaging Science
Background:
- Left ventricular (LV) mass is linked to atherosclerotic heart disease, but underlying mechanisms remain unclear.
- Investigating risk factors for LV mass and subclinical coronary atherosclerosis is crucial, especially in disease-free populations.
Purpose of the Study:
- To evaluate risk factors for LV mass and subclinical coronary atherosclerosis.
- To assess the combined impact of blood pressure and LV mass on coronary artery calcium in an Asian population.
Main Methods:
- The SingHEART study utilized ambulatory blood pressure monitoring and cardiac MRI.
- Indexed LV mass index (LVMI) and coronary artery calcium (CAC) scoring were measured.
- Logistic regression analyzed the interaction of BP and LVMI on prevalent CAC.
Main Results:
- Higher blood pressure was observed in individuals with high LVMI.
- Elevated blood pressure correlated with the presence of CAC across all LVMI groups.
- Hypertension significantly increased the risk of prevalent CAC, particularly when combined with high LVMI (RR 1.72).
Conclusions:
- Hypertension emerged as the primary risk factor for high LVMI and prevalent CAC in this healthy cohort.
- LV hypertrophy acts as a risk modifier, warranting further investigation into its prognostic value in normotensive individuals.
Background:
Left ventricular (LV) mass is closely associated with atherosclerotic heart disease, but the mechanisms are not well defined. This study aimed to evaluate the risk factors associated with LV mass and subclinical coronary atherosclerosis, in an Asian population free of baseline cardiovascular disease.
Methods:
The SingHEART study is a population-based cohort in which individuals underwent ambulatory blood pressure (BP) monitoring, cardiac MRI to measure indexed LV mass index (LVMI) and coronary artery calcium (CAC) scoring. Individuals were stratified based on LVMI and the presence of CAC, and intergroup differences in risk factors were analysed. Logistic regression models were used to assess the interaction of BP and LVMI on prevalent CAC.
Results:
The study included 880 subjects (mean age 45.8±11.7 years, 51.4% women). Individuals with high LVMI had higher BP than those with normal LVMI. Across all LVMI groups, higher BP was associated with the presence of CAC. Compared with individuals with normotensive BP and normal LVMI, those with normotensive BP and high LVMI had no increased risk of prevalent CAC (p=0.530); however, risk was progressively higher in those with hypertensive BP and normal LVMI (risk ratio (RR) 1.47, 95% CI 1.13 to 1.91), or hypertensive BP and high LVMI (RR 1.72, 95% CI 1.26 to 2.36).
Conclusions:
In this healthy asymptomatic population, hypertension was the strongest risk factor for high LVMI and prevalent CAC. LV hypertrophy was a risk modifier, and its prognostic significance in adults without hypertension requires further study.
Related Concept Videos
01:17Measurement of Blood Pressure
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...