This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: 119/24/3085    most recent CIRCULATIONAHA.108.824243v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Lieb, W. Articles by Vasan, R. S. PubMed PubMed Citation Articles by Lieb, W. Articles by Vasan, R. S. Related Collections Risk Factors Hypertrophy Echocardiography Epidemiology Related Article

(Circulation. 2009;119:3085-3092.)
© 2009 American Heart Association, Inc.

Epidemiology

Longitudinal Tracking of Left Ventricular Mass Over the Adult Life Course

Clinical Correlates of Short- and Long-Term Change in the Framingham Offspring Study

Wolfgang Lieb, MD; Vanessa Xanthakis, MS; Lisa M. Sullivan, PhD; Jayashri Aragam, MD; Michael J. Pencina, PhD; Martin G. Larson, ScD; Emelia J. Benjamin, MD, ScM; Ramachandran S. Vasan, MD

From the Framingham Heart Study, Framingham (W.L., M.J.P., M.G.L., E.J.B., R.S.V.), Department of Mathematics (M.J.P., M.G.L.) and Department of Biostatistics, Boston University School of Public Health (V.X., L.M.S.), and Preventive Medicine and Cardiology Sections (E.J.B., R.S.V.), Boston University School of Medicine, and Harvard Medical School, Boston, Mass (J.A.).

Correspondence to Dr Ramachandran S. Vasan, Framingham Heart Study, 73 Mount Wayte Ave, Framingham, MA 01702–5803. E-mail vasan{at}bu.edu

Received September 24, 2008; accepted April 6, 2009.

Background— Information is limited on the longitudinal tracking of left ventricular (LV) mass over the adult life course and the determinants of such change.

Methods and Results— We used multilevel modeling to evaluate the correlates of LV mass prospectively over a 16-year period in 4217 Framingham study participants (mean age 45 years, 53% women) using up to 4 serial routine echocardiographic observations on each individual (11 762 observations). Age, sex, body mass index, systolic blood pressure, antihypertensive treatment, smoking, and diabetes mellitus were related to longitudinal measures of LV mass. Women and participants with diabetes mellitus experienced a steeper increase in LV mass with advancing age (compared with men and those without diabetes mellitus; P for interactions <0.0001 and 0.0003, respectively). Women also displayed greater increments in LV mass with increasing body mass index (compared with men, P=0.04 for interaction). Participants with optimal values of these risk factors experienced lesser increases in LV mass over time. Analyses evaluating short-term (4-year) changes in LV mass (2605 unique individuals providing 4494 observations) identified the same key determinants that influenced its long-term trajectory (ie, body mass index, sex, systolic blood pressure, antihypertensive treatment, and smoking).

Conclusions— Our longitudinal observations on a large community-based sample identified higher blood pressure, excess adiposity, smoking, and diabetes mellitus as fundamental determinants of LV mass tracking over the adult life course. These observations are consistent with the notion that maintenance of optimal levels of these risk factors in midlife will reduce the burden of LV hypertrophy, and possibly heart failure, in older age.

---

 

CLINICAL PERSPECTIVE

Related Article:

Circulation: Clinical Summaries
Circulation 2009 119: 3041-3043. [Extract] [Full Text]