Abstract 3279: Endothelial Function During Adolescence Predicts Left Ventricular Mass in Early Adult Life
Background: Endothelial function may influence the development of ventricular hypertrophy through modification of arterial stiffness or myocardial biology.
Hypothesis: We hypothesed endothelial dysfunction during adolescence and early adult life is associated with increased left ventricular mass independent of hypertension or obesity.
Methods: Endothelial function was assessed by flow mediated dilatation (FMD) of the brachial artery using high resolution ultrasound (Philips Sonos) in 30 subjects, aged 15 years (17 females). Subjects returned at age 23 to 26 years for assessment of left ventricular mass (LVM) by cardiovascular magnetic resonance (1.5T Siemens Sonata) and reassessment of FMD using the same method. Cardiovascular risk factors including body size, blood pressure, lipid profile, glucose tolerance and smoking were measured at both time points.
Results: FMD at age 15 was significantly associated with LVM ten years later (r −0.41, 0.02) with greater endothelial responses related to reduced LVM. FMD in early adulthood was similarly associated with LVM (r-0.55, 0.002) and also correlated with FMD at age 15 (r=0.35, P=0.02). Subjects with FMD consistently above the mean at both 15 and 25 years had significantly lower LVM (adjusted for body surface area) compared to those with FMD below the mean at any time (57g/m2 v 68g/m2 p<0.05). In a multivariate regression model of LVM, adjusted for body surface area, including cardiovascular risk factors, FMD was the strongest independent predictor of LVM.
Conclusion: Endothelial function during adolescence predicts left ventricular mass ten years later. Individuals with consistently high endothelial responses over this time period have the lowest left ventricular mass. Endothelial function may influence cardiac structure in young people even in the absence of classical risk factors such as hypertension and obesity.