Key result
Lower age, BMI, office systolic blood pressure (OR 0.97; 95% CI 0.95-0.99), and fasting blood glucose were independently associated with persistent normal left ventricular geometry over 25 years.
Why the study?
Data regarding the persistence over time of normal LV geometry in the general population are scanty.
What factors are associated with the persistence of normal left ventricular geometry over a 25-year follow-up in the general population?
Cohort (n=433)
What factors are associated with the persistence of normal left ventricular geometry over a 25-year follow-up in the general population?
Answers are grounded in this paper and cite their sources.
Optimal systolic blood pressure, BMI, and fasting blood glucose are independently associated with the long-term persistence of normal left ventricular geometry.
AIM: Findings regarding the extent of persistence over time of normal left ventricular (LV) geometry, a reference healthy echocardiographic phenotype, in the community are scanty. We sought to assess this issue in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study. METHODS: The study included 433 participants who attended the second and third survey of the Pressioni Arteriose Monitorate e Loro Associazioni study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, office, home, ambulatory blood pressure, routine blood examinations and echocardiography. RESULTS: During 25-year follow-up 167 participants showed persistently normal LV mass (LVM) and LV geometry pattern, whereas 266 participants exhibited LV hypertrophy or LV concentric remodelling at any point during study. Compared with participants developing, maintaining or regressing from LV hypertrophy and LV concentric remodelling those with a persistently normal LVM index and geometry were younger (-8 years) and more frequently female (63 vs. 45%), exhibited baseline (and follow-up) lower office and out-of-office blood pressure, BMI, serum creatinine, fasting blood glucose total serum cholesterol and rate of antihypertensive treatment. In multivariate regression analysis age [odds ratio (OR): 0.93, confidence interval (CI): 0.91-0.96, P < 0.0001] BMI (OR: 0.90, CI: 0.83-0.97, P = 0.008), office SBP (OR: 0.97, CI: 0.95-0.99, P = 0.005) and fasting blood glucose (OR: 0.96, CI: 0.93-0.99, P = 0.007) were independently associated with persistent normal LVM index and geometry. CONCLUSION: The current long-term longitudinal study suggests that persistence of normal LV geometry is associated with normal/optimal SBP, BMI and blood glucose. Thus, a closer control of these risk factors in midlife may increase the likelihood of maintaining normal ventricular geometry and, in turn, reduce the burden of subclinical cardiac organ damage and related complications in advanced age.
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Cuspidi et al. (2020) conducted a cohort in Left ventricular hypertrophy / normal left ventricular geometry (n=433). Risk factors (age, BMI, office SBP, fasting blood glucose) vs. Higher levels of risk factors was evaluated on Persistent normal LVM index and geometry (association with office SBP) (OR 0.97, 95% CI 0.95-0.99, p=0.005). Lower age, BMI, office systolic blood pressure (OR 0.97; 95% CI 0.95-0.99), and fasting blood glucose were independently associated with persistent normal left ventricular geometry over 25 years.
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