Aim: We sought to evaluate new-onset abnormal LV (left ventricle) patterns and their correlates over a 10-year period in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study. Methods: The study included 817 patients with normal LV geometry at baseline evaluation having a readable echocardiogram at the end of follow-up. Cut-points for abnormal LV geometric patterns were derived from reference values of the healthy fraction of the Pressioni Arteriose Monitorate e Loro Associazioni population. Results: Over a 10-year period 39% of participants progressed to abnormal LV geometric patterns as follows: LV concentric remodelling (15.2%), eccentric dilated left ventricular hypertrophy (LVH) (8.4%), concentric LVH (7.9%), eccentric nondilated LVH (6.8%), and concentric dilated LVH (0.7%). Age [odds ratio (OR): 1.039; 95% confidence interval (CI) 1.023-1.056, P<0.0001], LV mass index (OR: 1.039; 95% CI 1.026-1.052, P<0.0001), night-time SBP (OR: 1.024; 95% CI 1.005-1.043, P=0.01), office SBP changes during follow-up (OR: 1.017 95% CI 1.007-1028, P=0.001), and BMI (OR: 1.067; 95% CI 1.017-1.120, P=0.009) emerged as key correlates of new-onset abnormal LV geometry. Age and LV mass index turned out to be strong determinants of all sub-types of LVH; whereas blood pressure, BMI, and sex exhibited a different predictive value across the various LV geometric patterns. Conclusions: Our study provides the first evidence that long-term changes from normal cardiac morphology toward abnormal LV geometry represent a clinically relevant phenomenon at the community level. From a practical perspective this finding reinforces the concept that life-style changes and pharmacologic treatment aimed to reduce over-weight/obesity and optimize blood pressure are of paramount importance for prevention of subclinical cardiac damage.

Cuspidi, C., Facchetti, R., Bombelli, M., Sala, C., Tadic, M., Grassi, G., et al. (2016). Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: The PAMELA study. JOURNAL OF HYPERTENSION, 34(7), 1423-1431 [10.1097/HJH.0000000000000956].

Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: The PAMELA study

CUSPIDI, CESARE
;
Facchetti, R;BOMBELLI, MICHELE;Sala, C;GRASSI, GUIDO;Mancia G.
2016

Abstract

Aim: We sought to evaluate new-onset abnormal LV (left ventricle) patterns and their correlates over a 10-year period in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study. Methods: The study included 817 patients with normal LV geometry at baseline evaluation having a readable echocardiogram at the end of follow-up. Cut-points for abnormal LV geometric patterns were derived from reference values of the healthy fraction of the Pressioni Arteriose Monitorate e Loro Associazioni population. Results: Over a 10-year period 39% of participants progressed to abnormal LV geometric patterns as follows: LV concentric remodelling (15.2%), eccentric dilated left ventricular hypertrophy (LVH) (8.4%), concentric LVH (7.9%), eccentric nondilated LVH (6.8%), and concentric dilated LVH (0.7%). Age [odds ratio (OR): 1.039; 95% confidence interval (CI) 1.023-1.056, P<0.0001], LV mass index (OR: 1.039; 95% CI 1.026-1.052, P<0.0001), night-time SBP (OR: 1.024; 95% CI 1.005-1.043, P=0.01), office SBP changes during follow-up (OR: 1.017 95% CI 1.007-1028, P=0.001), and BMI (OR: 1.067; 95% CI 1.017-1.120, P=0.009) emerged as key correlates of new-onset abnormal LV geometry. Age and LV mass index turned out to be strong determinants of all sub-types of LVH; whereas blood pressure, BMI, and sex exhibited a different predictive value across the various LV geometric patterns. Conclusions: Our study provides the first evidence that long-term changes from normal cardiac morphology toward abnormal LV geometry represent a clinically relevant phenomenon at the community level. From a practical perspective this finding reinforces the concept that life-style changes and pharmacologic treatment aimed to reduce over-weight/obesity and optimize blood pressure are of paramount importance for prevention of subclinical cardiac damage.
Articolo in rivista - Articolo scientifico
echocardiography; general population; new-onset abnormal left ventricular geometry;
new-onset left ventricular; geometric abnormalities
English
2016
34
7
1423
1431
none
Cuspidi, C., Facchetti, R., Bombelli, M., Sala, C., Tadic, M., Grassi, G., et al. (2016). Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: The PAMELA study. JOURNAL OF HYPERTENSION, 34(7), 1423-1431 [10.1097/HJH.0000000000000956].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/110116
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