Abstract P010: Relation of Left Ventricular Mass and Geometry to Incident Heart Failure in African Americans
Introduction. Studies in non-Hispanic whites suggest that early adaptive changes in cardiac structure due to hypertension (HTN) may influence the development of heart failure (HF). The relation of left ventricular (LV) structure to incident HF is less well-studied in African Americans (AA) despite the higher incidence of HTN and HF in this group.
Hypothesis. We hypothesized that incidence of HF in AA varies according to LV geometry type.
Methods. The study sample included 2,246 participants [mean age 59 years, 36.4% men] who attended the third examination cycle of the Jackson cohort of ARIC (1993-1995) and underwent echocardiography, anthropometry and phlebotomy for glucose and lipids. LV mass and geometric pattern [concentric and eccentric hypertrophy (CH and EH) and concentric remodeling] were determined using echocardiography and described by Ganau et al. Data on HF incidence on follow-up was available up to December 31, 2008. In the primary analyses we adjusted for age, sex, education, smoking and alcohol use, diabetes, body mass index, lipid profile, systolic BP, and lipid-lowering and HTN medications in the multivariable model. In secondary analysis, we assessed the relation in a subsample with HTN.
Results. In our study sample those with abnormal geometry (compared to those with normal geometry) tended to be older, more obese and more likely to have HTN, diabetes, and lower educational status. Over a mean follow-up period of 10 years (maximum 15 years), 297 participants developed HF. Incident HF was significantly related to LV mass [HR 1.13 (1.09, 1.18) per 10 gram change; P< 0.001]. The Table shows the distribution of LV geometric patterns in the study population and demonstrates that EH was significantly associated with greater HF risk. HTN influenced the relation of CH to HF risk (Table).
Conclusion. In our large community-based sample of AAs, we observed that greater LV mass and presence of EH were significantly related to higher HF risk. CH was associated with elevated HF risk only in the subsample with HTN.
- © 2013 by American Heart Association, Inc.