BIRTH-WEIGHT, WEIGHT AT ONE-YEAR, AND LEFT-VENTRICULAR MASS IN ADULT LIFE

Objective-To examine how fetal and infant growth are related to left v entricular mass in adult life. Design-A follow up study of men born du ring 1920-30 whose birth weights and weights at 1 year were recorded. Setting-Hertfordshire, England. Subjects-290 men born and still living in East Hertfordshire, England. Main outcome measure-left ventricular mass calculated from measurements of interventricular septal thicknes s and left ventricular posterior walt thickness and left ventricular i nternal diameter at end diastole measured by M mode echocardiography. Results-Left ventricular mass was highest in men with the lowest weigh t at 1 year and fell with increasing weight at 1 year (r = 0.18, P = 0 .01). Left ventricular mass was not related to birth weight. The relat ion with weight at 1 year was independent of factors in adult life kno wn to influence left ventricular mass, including body size, systolic b lood pressure, and age. The enlarged left ventricular mass associated with reduced growth in infancy was concentric, affecting both the inte rventricular septum and the left ventricular posterior wall. Concentri c left ventricular hypertrophy is known to be associated with increase d death rates from coronary artery disease. Conclusion-Low weight at 1 year is associated with concentric enlargement of the left ventricle in adult life. This is consistent with a previous finding of higher mo rtality from cardiovascular disease in men of low weight at 1 year, an d provides further evidence that cardiovascular disease may be partly programmed in early life. The left ventricular enlargement may be a lo ng term result of haemodynamic changes in utero or of persisting chang es in growth factor concentrations.