Objective It is well known that left ventricular (LV) structural alterations were associated with increased cardiovascular risk factors in a middle-aged and older population; however, cardiovascular risk factors are more prevalence in young adults and strongly associated with adverse LV geometry. The aim of this study was to determine the cardiovascular risk predictors of LV geometric remodelling in a population of young adults.
Methods 515 subjects were selected for this study (age range 23–45 years, average 35; 64% men). LV structure was measured by a two-dimensional guided M-mode echocardiography. Normal geometry, concentric remodelling, eccentric and concentric hypertrophy were defined by LV relative wall thickness and LV mass indexed to height (gram/height in m2.7). Multivariable logistic regression analyses were performed to define young adulthood determinants of LV geometric patterns.
Results The prevalence of normal geometry, concentric remodelling, eccentric and concentric hypertrophy were 79.0%, 7.6%, 8.7% and 4.7% respectively. Males showed significantly higher prevalence for concentric remodelling and eccentric hypertrophy than females (5.6% vs 2.0% and 6.4% vs 2.3%, p<0.01), however such differences were not noted for normal geometry and concentric hypertrophy (p>0.05). Using the normal geometry group as reference, individuals with eccentric and concentric hypertrophy showed significantly higher levels of BMI (36.3 kg/m2 and 38.6 kg/m2 vs 27.2 kg/m2, p<0.001), SBP (127.5 mm Hg and 137.2 mm Hg vs 114.7 mm Hg, p<0.001), DBP (85.2 mm Hg and 89.7 mm Hg vs 73.5 mm Hg, p<0.01), glucose (111.2 mg/dl and 129.3 mg/dl vs 85.2 mg/dl, p<0.01), DM (24.3% and 41.6% vs 4.3%, p<0.001) and triglycerides (156.8 mg/dl vs 128.5 mg/dl, p<0.001) and total/HDL-C ratio (4.9 vs 4.1, p<0.01) were higher significantly in eccentric hypertrophy only. However, none of these risk factors differed significantly between normal geometry and concentric remodelling groups (p>0.05). In Multivariable logistic regression models age, gender, BMI, SBP, DBP, glucose, DM, triglycerides and total/HDL-C ratio, male gender was related to concentric remodelling hypertrophy (OR=2.63, 95% CI 1.21 to 5.64, p=0.019), BMI was related to eccentric hypertrophy (OR=1.162, 95 % CI 1.08 to 1.20, p<0.001) and DM was related to concentric hypertrophy (OR=6.354, 95% CI 3.24 to 35.0, p=0.002).
Conclusions These findings showed that eccentric hypertrophy and concentric hypertrophy were more frequent and male gender, obesity and DM were significant determinants of these patterns of adverse cardiac remodelling in young adults.