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Epidemiology
Original article
Secular trends in echocardiographic left ventricular mass in the community: the Framingham Heart Study
  1. Bernhard M Kaess1,2,3,
  2. Philimon Gona1,4,
  3. Martin G Larson1,5,
  4. Susan Cheng6,
  5. Jayashree Aragam7,8,
  6. Satish Kenchaiah9,
  7. Emelia J Benjamin1,9,10,
  8. Ramachandran S Vasan1,8
  1. 1National Heart, Blood and Lung Institute's and Boston University's Framingham Heart Study, Framingham, Massachusetts, USA
  2. 2Deutsches Herzzentrum, Technische Universität, Munich, Germany
  3. 3Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany
  4. 4Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  5. 5Mathematics and Statistics Department, Boston University, Boston, Massachusetts, USA
  6. 6Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  7. 7Veterans Administration Hospital, West Roxbury, Massachusetts, USA
  8. 8Harvard Medical School, Boston, Massachusetts, USA
  9. 9Sections of Preventive Medicine and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
  10. 10Department of Epidemiology, Boston University School of Public Health, Framingham, Massachusetts, USA
  1. Correspondence to Dr Ramachandran S Vasan, Framingham Heart Study, 73 Mt Wayte Ave, Suite 2, Framingham, MA 01702–5803, USA; vasan{at}bu.edu

Abstract

Objective To investigate secular trends in echocardiographically determined left ventricular mass (LVM).

Design, setting and participants Longitudinal community-based cohort study in Framingham, Massachussetts. LVM was calculated from routine echocardiography in 4320 participants (52% women) of the Framingham offspring cohort at examination cycles 4 (1987–1991), 5 (1991–1995), 6 (1995–1998) and 8 (2005–2008), totalling 13 971 person-observations.

Main outcome measures Sex-specific trends in mean LVM (and its components, LV diastolic diameter (LVDD) and LV wall thickness (LVWT)), and LVM indexed to body surface area (BSA).

Results In men, age-adjusted LVM modestly increased from examination 4 to 8 (192 g to 198 g, p-trend=0.0005), whereas, in women it decreased from 147 g at examination 4 to 140 g at examination 8 (p-trend<0.0001). The trend for increasing LVM in men tracked with an increasing LVDD (p-trend=0.0002), whereas the decline in LVM in women was accompanied by a decrease in LVWT (p-trend<0.0001). Indexing LVM to BSA abolished the increasing trend in men (p-trend=0.49), whereas, the decreasing trend in women was maintained.

Conclusions In our longitudinal analysis of a large community-based sample spanning two decades, we observed sex-related differences in trends in LVM, with a modest increase of LVM in men (likely attributable to increasing body size), but a decrease in women. Additional studies are warranted to elucidate the basis for these sex-related differences.

https://doi.org/10.1136/heartjnl-2013-304600

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