Abstract 1694: Left Ventricular Hypertrophy and Lifetime Predicted Risk for Cardiovascular Disease: The Dallas Heart Study
Background: We hypothesized that individuals with low short term risk for coronary heart disease (CHD) but high lifetime predicted risk for atherosclerotic cardiovascular disease (CVD) would have greater prevalence of left ventricular (LV) hypertrophy (LVH) than those with low short term and low lifetime risk.
Methods: We stratified subjects in Dallas Heart Study who had cardiac MRI and were ≤ 50 years (N = 1891) into 3 groups: low short term (< 10% 10-year risk for CHD)/low lifetime predicted risk (< 39% lifetime risk for CVD), low short term (< 10%)/high lifetime risk (≥39%), and high short term risk (≥10% or prevalent diabetes). In those with low short term risk, we compared age-adjusted LV mass, end-diastolic volume (EDV), wall thickness, concentricity (LV mass/EDV), and prevalent LVH between those with low vs. high lifetime risk.
Results: Compared to subjects with low short term/low lifetime risk, those with low short term/high lifetime risk had increased LV mass, wall thickness, concentricity, but similar EDV (Table 1⇓). LVH, either indexed to height2.7 or BSA was 1.7 (95% CI: 1.3–2.3) and 3.6 (95% CI: 2.0 – 6.5) fold more common (respectively) in those with high lifetime risk in this comparison (p < 0.001). The association of high lifetime risk with markers of concentric LVH persisted in subjects without detectable coronary artery calcium (CAC) (Table 2⇓).
Conclusions: Among individuals with low short term risk, a high lifetime predicted risk for CVD is associated with concentric LVH. This association persists among those without CAC, suggesting that LVH may provide an additional mechanistic explanation for increased event rates associated with high predicted lifetime risk for CVD.