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Echocardiographic left ventricular systolic function and volumes in young adults: distribution and factors
N D Wong1, J M Gardin, T Kurosaki
1Preventive Cardiology Program, University of California, Irvine 92717.
Insights
In healthy young adults, left ventricular ejection fraction (LVEF) varies by gender and risk factors. Male gender, hypertension history, and smoking are linked to lower LVEF, impacting cardiac health.
Area of Science:
- Cardiology
- Echocardiography
- Public Health
Background:
- Low left ventricular ejection fraction (LVEF) signifies systolic dysfunction and predicts adverse cardiac events.
- Limited data exist on LVEF distribution in healthy young adults and its relation to cardiac risk factors.
Purpose of the Study:
- To determine the distribution of resting LVEF and component volumes in young adults.
- To investigate associations between LVEF, left ventricular volumes, and coronary risk factors.
Main Methods:
- Two-dimensional echocardiography measured LVEF, LVEDV, and LVESV in 1782 participants (23-35 years old).
- Analyzed factors included demographics, blood pressure, lipids, lifestyle, and fitness.
- Multivariate analysis identified independent predictors of LVEF and ventricular volumes.
Main Results:
- LVEF was slightly lower in men than women (p < 0.01); 90% had LVEF between 53%-71%.
- Left ventricular end-diastolic volume (LVEDV) and end-systolic volume (LVESV) were >25% greater in men.
- Male gender, hypertension, and smoking independently predicted lower LVEF. BSA, family history of MI, and fitness related to LVEDV/LVESV.
Conclusions:
- Establishes normative LVEF and volume ranges for young adults.
- Identifies key demographic and modifiable risk factors associated with LVEF and ventricular dimensions in this population.
Abstract:
Low left ventricular ejection fraction (LVEF), a measure of global systolic left ventricular dysfunction, is associated with an increased risk of recurrent coronary events or death in persons with cardiac disease. There are few data on the distribution of resting LVEF and component volumes in healthy young adults or on any association of LVEF with coronary risk factors. LVEF and left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV, respectively) were measured by two-dimensional echocardiography in 1782 men and women 23 to 35 years old without self-reported heart disease (other than mitral valve prolapse, n = 53) who were participants in the multicenter Coronary Artery Risk Development in Young Adults study. Factors analyzed as potential contributors to LVEF, LVEDV, and LVESV included age, gender, race, blood pressure, alcohol use, current smoking, family history of myocardial infarction, total and high-density lipoprotein cholesterol concentrations, obesity, reported physical activity, and fitness as assessed by treadmill exercise testing. LVEF was lower in men (mean 62.6% SD 5.7%) than in women (mean 63.9%, SD 5.7%) (p < 0.01) but did not differ significantly between black and white subjects. Ninety percent of subjects had an LVEF between 53% and 71%. LVEDV and LVESV were > 25% greater in men than in women. From multivariate analysis, male gender, history of hypertension, and current smoking were each positively and independently associated with an approximately 1% lower LVEF. Body surface area, a family history of premature myocardial infarction, and treadmill workload 150 time were positively related, whereas total skinfold thickness was negatively related to LVEDV and LVESV.(ABSTRACT TRUNCATED AT 250 WORDS)