Ethnicity-Related Differences in Left Ventricular Function, Structure and Geometry: A Population Study of UK Indian Asians and European Whites

Navtej S Chahal ¹, Tiong K Lim ¹, Piyush Jain ², John C Chambers ², Jaspal S Kooner ² and Roxy Senior ^1*

¹ Northwick Park Hospital, United Kingdom
² Imperial College London, United Kingdom

^* To whom correspondence should be addressed. E-mail: roxysenior{at}cardiac-research.org.

Accepted 23 June 2009

Abstract

Objectives: We studied healthy UK Indian Asian and European white subjects to assess whether functional, structural and geometrical properties of the left heart are intrinsically related to ethnicity.

Background: Quantitative assessment of cardiac function and structure is necessary to diagnose heart failure syndromes and is validated to refine risk prediction. A better understanding of the demographic factors that influence these variables is required.

Methods: 453 healthy subjects were recruited from the London Life Sciences Prospective Population (LOLIPOP) study. They underwent 2-D and tissue Doppler echocardiography for quantification of left ventricular (LV) function, LV volumes, left atrial volume index (LAVI), left ventricular mass index (LVMI) and relative wall thickness (RWT).

Results: Indian Asians had attenuated mitral annular systolic velocity (8.9 cm/s vs. 9.5 cm/s, p<0.001), lower mitral annular early diastolic velocity (10.3 cm/s vs. 11.0 cm/s, p<0.001) and higher E/Ea ratio (7.9 vs. 7.0, p<0.001) compared to European whites. Although Indian Asians had significantly smaller left heart volumes and LVMI, they had a significantly higher RWT (0.37 vs. 0.35, p<0.001). After adjustment for covariates, these ethnicity-related differences remained highly significant (p<0.001).

Conclusion: Compared to European whites, Indian Asians have attenuated longitudinal LV function, higher LV filling pressure and demonstrate a greater degree of concentric remodeling independent of other demographic and clinical parameters.