From the Division of Cardiology, Veterans General Hospital, Taipei,
Taiwan (C.-H.C., S.-J.L., T.-L.H., S.-J.H., M.-S.C.); the Division of
Cardiology, Veterans General Hospital, Taichung, Taiwan and National Yang Ming
University, Taiwan (C.-T.T.); the Institute of Public Health, National
Yang-Ming University, Taiwan (P.C.); Gerontology Research Center, National
Institute on Aging, Baltimore, Md (F.O., H.S., E.L.); and the Division of
Cardiology, Johns Hopkins University School of Medicine, Baltimore, Md
(F.C.P.Y.).
Correspondence to Frank C.P. Yin, MD, PhD, Department of Biomedical Engineering, Campus Box 1097, One Brookings Dr, Washington University, St Louis, MO 63130. E-mail yin{at}biomed.wustl.edu
Background—Many
cardiovascular and noncardiovascular
parameters are thought to be determinants of left
ventricular mass (LVM). Complicated interactions
necessitate the simultaneous measurement and consideration
of each to determine their individual and collective impact on LVM. We
undertook such a comprehensive study.
Methods and Results—The influence of anthropometry, cardiac size
and contractility, arterial structure and
function, as well as indices of lifestyle, physical activity, and
dietary salt intake on LVM (by two-dimensionally guided M-mode
echocardiography) was analyzed in 1315
Chinese subjects who were either normotensive or had untreated
hypertension. Effects of many cardiac and arterial factors
were assessed. In univariate analysis, almost all
measured noncardiovascular, cardiac, and
arterial variables were significantly correlated with
LVM. In multivariate linear regression
analyses, when age, sex, body habitus, fasting serum C-peptide
level, dietary salt, physical activity, and lifestyle were accounted
for, the optimum multivariate linear regression main
effects model had an adjusted model r2 of
0.740, with 98% of the model variance accounted for by the 5
independent determinants of LVM: stroke volume (49.6%),
systolic blood pressure (30.7%), contractility
(14.7%), body mass index (1.8%), and aortic root diameter (1.6%).
Other proposed arterial indices were significant
independent determinants of LVM only when blood pressure was removed
from the model and, even then, these indices not only resulted in less
powerful prediction but also accounted for only a very small percentage
of the total variance of LVM.
Conclusions—In a large population, we (1) confirmed that age,
body habitus, and some indexes of arterial structure and
function are independent determinants of LVM; (2) found aortic diameter
to be an independent structural determinant of LVM; (3) demonstrated
that the effects of the derived measures of arterial
function were small and provided no better predictive power than blood
pressure alone; and (4) showed that when the best measures of cardiac
and vascular load were included, the single most potent predictor was
an index of left ventricular size.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Which Arterial and Cardiac Parameters Best Predict Left Ventricular Mass?
Key Words: hypertrophy • cardiac load • arterial system • vascular load • blood pressure
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