A 25-Year Longitudinal Gender-Based Study on Left Ventricular Geometry Tracking in the General Population: The Pamela Study

Background Longitudinal findings on the relationship between sex, aging and left ventricular (LV) geometric patterns in population-based cohorts with a low prevalence of risk factors, are still scarce. We investigated this issue in the participants of the third survey of Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study in which echocardiographic data were prospectively collected over a 25-year period. Methods 420 participants who attended the initial survey (1990-1993) and two subsequent ones, 10 (2001-2003) and 25 years later (2017-2018), were included in the analysis. LV geometric patterns were defined according to American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) guidelines. Results The prevalence of LV concentric geometry (i.e. relative wall thickness ≥ 0.43) increased progressively across the three surveys in both men: 11.5 (CI: 7.8-16.7), 29.0 (CI: 23.1-35.6), 53.0% (CI: 46.1-59.8), p < 0.001 and women: 5.5 (CI: 3.1-9.3), 14.9 (CI: 10.5-19.8), 36.8% (CI: 30.7-43.4), p < 0.001. Contrary to what found for other patterns, the prevalence of concentric LV hypertrophy (LVH) showed a different sex-specific behaviour, i.e. a gradual increase in women from the first to the third survey: 1.4 (CI: 0.5-2.4), 5.0 (CI: 2.8-8.3), 13.6% (CI: 9.7-18.8), p < 0.001) and a decline from second to third survey in men: 0.5 (CI: 0.1-2.8), 9.0 (CI: 5.8-13.9), 7.5% (CI: 4.6-12.0), p < 0.05). Conclusions Our findings show that aging is accompanied by a marked increase in concentric geometry in both sexes, and suggest that women are at higher risk of developing concentric LVH.