Key result
An increasing number of cardiovascular risk factors progressively decreased LV longitudinal systolic velocity at rest and peak stress (P<0.0001), while radial systolic velocity increased (P<0.01).
Why the study?
Does the accumulation of major cardiovascular risk factors impair subclinical regional left ventricular function in asymptomatic subjects?
Observational (n=246)
Does the accumulation of major cardiovascular risk factors impair subclinical regional left ventricular function in asymptomatic subjects?
p-value: p=<0.0001
The accumulation of major cardiovascular risk factors in asymptomatic subjects is associated with progressive impairment of LV long-axis function, which is initially maintained by compensatory increases in radial function.
Risk factor accumulation may impair subclinical long-axis LV function in asymptomatic subjects; hypothesis-generating for compensatory radial changes and prognostic relevance.
BACKGROUND: The risk factors that contribute to atherosclerosis also predict clinical heart failure, but it is unclear how they affect myocardial function. Aims were to assess if major cardiovascular risk factors cause subclinical myocardial dysfunction in asymptomatic subjects. METHODS: We measured regional left ventricular (LV) function at rest and during dobutamine stress echocardiography in 246 subjects (54 ± 12 years, 54% men) analyzed in five groups according to the presence of six risk factors (diabetes, hypertension, obesity, dyslipidemia, smoking, and family history; age was similar in the five groups). LV longitudinal function was assessed from the mean velocities of four basal segments, and radial function from the velocities of the basal posterior wall. RESULTS: Risk factors did not affect LV ejection fraction, but longitudinal systolic velocity decreased progressively with the number of risk factors, at rest (6.8 ± 1.3 vs. 6.2 ± 1.6 vs. 5.8 ± 1.5 vs. 5.4 ± 1.3 vs. 5.3 ± 1.3 cm/sec, for the five groups, respectively) and at peak stress (14.3 ± 3.3 vs. 12.9 ± 3.2 vs. 11.8 ± 3.4 vs. 11.3 ± 2.6 vs. 11.1 ± 2.3 cm/sec) (both P < 0.0001). Radial systolic velocity increased according to the number of risk factors (P < 0.01). By multivariate regression, determinants of reduced longitudinal systolic velocity at rest were body mass index, diastolic blood pressure, age, and fasting plasma glucose (r = 0.57, r(2) = 0.32, P < 0.0001). CONCLUSION: Asymptomatic subjects have impaired LV long-axis function at rest and during stress, according to their number of major cardiovascular risk factors. Global LV systolic function is maintained by compensatory increases in radial function. These changes provide new targets for preclinical diagnosis and for monitoring responses to preventive strategies.
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Vinereanu et al. (2011) conducted an observational in Asymptomatic subjects with cardiovascular risk factors (n=246). Major cardiovascular risk factors vs. Fewer or no cardiovascular risk factors was evaluated on LV longitudinal systolic velocity at rest and peak stress (p=<0.0001). An increasing number of cardiovascular risk factors progressively decreased LV longitudinal systolic velocity at rest and peak stress (P<0.0001), while radial systolic velocity increased (P<0.01).
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