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Which arterial and cardiac parameters best predict left ventricular mass?
Insights
Left ventricular mass (LVM) is influenced by stroke volume, systolic blood pressure, and contractility. These cardiac and vascular factors are key determinants of LVM in large populations.
Area of Science:
- Cardiology
- Cardiovascular Research
- Clinical Physiology
Background:
- Left ventricular mass (LVM) is influenced by numerous cardiovascular and noncardiovascular factors.
- Understanding the complex interplay of these determinants is crucial for assessing their impact on LVM.
Purpose of the Study:
- To comprehensively analyze the individual and collective impact of various parameters on LVM.
- To identify the primary determinants of LVM in a large Chinese population.
Main Methods:
- Two-dimensionally guided M-mode echocardiography was used to measure LVM.
- 1315 normotensive or untreated hypertensive Chinese subjects were analyzed.
- Multivariate linear regression models were employed to assess determinant significance.
Main Results:
- Stroke volume, systolic blood pressure, contractility, body mass index, and aortic root diameter were identified as key independent determinants of LVM.
- These five factors accounted for 98% of the model variance in LVM.
- Arterial function indices showed limited predictive power for LVM compared to blood pressure.
Conclusions:
- Age, body habitus, and arterial structure/function are confirmed independent determinants of LVM.
- Aortic diameter is a significant structural determinant of LVM.
- Cardiac and vascular load measures, particularly stroke volume, are potent predictors of LVM.
Background:
Many cardiovascular and noncardiovascular parameters are thought to be determinants of left ventricular mass (LVM). Complicated interactions necessitate the simultaneous measurement and consideration of each to determine their individual and collective impact on LVM. We undertook such a comprehensive study.
Methods And Results:
The influence of anthropometry, cardiac size and contractility, arterial structure and function, as well as indices of lifestyle, physical activity, and dietary salt intake on LVM (by two-dimensionally guided M-mode echocardiography) was analyzed in 1315 Chinese subjects who were either normotensive or had untreated hypertension. Effects of many cardiac and arterial factors were assessed. In univariate analysis, almost all measured noncardiovascular, cardiac, and arterial variables were significantly correlated with LVM. In multivariate linear regression analyses, when age, sex, body habitus, fasting serum C-peptide level, dietary salt, physical activity, and lifestyle were accounted for, the optimum multivariate linear regression main effects model had an adjusted model r2 of 0.740, with 98% of the model variance accounted for by the 5 independent determinants of LVM: stroke volume (49.6%), systolic blood pressure (30.7%), contractility (14.7%), body mass index (1.8%), and aortic root diameter (1.6%). Other proposed arterial indices were significant independent determinants of LVM only when blood pressure was removed from the model and, even then, these indices not only resulted in less powerful prediction but also accounted for only a very small percentage of the total variance of LVM.
Conclusions:
In a large population, we (1) confirmed that age, body habitus, and some indexes of arterial structure and function are independent determinants of LVM; (2) found aortic diameter to be an independent structural determinant of LVM; (3) demonstrated that the effects of the derived measures of arterial function were small and provided no better predictive power than blood pressure alone; and (4) showed that when the best measures of cardiac and vascular load were included, the single most potent predictor was an index of left ventricular size.