Preventive cardiology
Relation of Childhood Risk Factors to Left Ventricular Hypertrophy (Eccentric or Concentric) in Relatively Young Adulthood (from the Bogalusa Heart Study)

https://doi.org/10.1016/j.amjcard.2008.01.045Get rights and content

Left ventricular (LV) structural alterations were associated with increased cardiovascular morbidity and mortality in a middle-aged and older population. The aim of this study was to determine childhood and adulthood cardiovascular risk predictors of LV geometric remodeling in a biracial (black-white) population of young adults. As part of the Bogalusa Heart Study, echocardiographic examinations of the heart were performed in 824 adults (age range 24 to 44 years, average 36; 41% men, 69% white) who had risk-factor variables in their childhood. Eccentric LV hypertrophy and concentric remodeling were the most commonly encountered LV geometric changes in this young adult population (4.7% vs 1.8% for concentric LV hypertrophy). In adulthood, subjects with eccentric and/or concentric LV hypertrophy compared with normal geometry were more likely to be obese and/or diabetic and had significantly increased body mass index, waist circumference, systolic and diastolic blood pressures, glucose, insulin, hemoglobin A1c, total/high-density lipoprotein cholesterol ratio, triglycerides, and urinary albumin-creatinine ratios. In multinomial logistic regression analyses, both adulthood and childhood body mass index were significant determinants of eccentric LV hypertrophy (odds ratios [ORs] 1.15 and 1.19). The presence of diabetes mellitus in adulthood (OR 8.25) and diastolic blood pressure in childhood (OR 1.14) were significant predictors of concentric LV hypertrophy. In adults, blacks had higher ORs for concentric LV hypertrophy and related to diabetes and systolic blood pressure. In conclusion, in this community-based study of young adults, eccentric LV hypertrophy was more frequent and obesity since childhood was the only consistent and significant determinant of this type of adverse cardiac remodeling.

Section snippets

Methods

The Bogalusa Heart Study was a long-term epidemiologic study of the early natural history of arteriosclerosis in children and young adults from a semirural biethnic (65% white, 35% black) community in Bogalusa, Louisiana.1 As a part of a longitudinal cohort survey, echocardiographic examinations of the heart were performed from 2000 to 2002. Eight hundred twenty-four eligible black and white adult subjects (age range 24 to 44 years, average 36; 41% men, 69% white) who had CV risk-factor

Results

As listed in Table 1, in this study cohort of 824 young adults, the prevalence of echocardiographic LV hypertrophy was 6.6%. Eccentric LV hypertrophy was present in 4.7%; concentric LV hypertrophy, in 1.8%; and concentric remodeling, in 4.7%. A total of 7.4% of men had concentric remodeling compared with 2.9% of women (p <0.01). Blacks had a significantly higher prevalence of eccentric (7.4%) and concentric LV hypertrophy (3.5%) compared with whites (3.5% and 1.1%, respectively). Subjects with

Discussion

The prevalence of echocardiographic LV hypertrophy was 6.6% in our biracial community-based sample of healthy young adults. We observed that eccentric LV hypertrophy (72% of LV hypertrophy) was more frequent than concentric LV hypertrophy, and black subjects had more LV hypertrophy than whites. BMI in both adulthood and childhood was a significant determinant of eccentric LV hypertrophy. Concentric LV hypertrophy was related to diabetes mellitus status in adulthood and diastolic blood pressure

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