Structural association between the carotid artery and the left ventricle in a general population in Northern Italy: the Vobarno study

Objective To evaluate the interrelationships between structural alterations in the carotid arteries and left ventricular geometric patterns in a middl e-aged general population, Design and methods We studied 223 untreated subjects (106 females, 117 male s; aged 48-64 years) living in a small town in Northern Italy (Vobarno, Bre scia), using a cross-sectional design. The left ventricular mass index was assessed by echocardiography, while the intima-media thickness and the occu rrence of plaque were evaluated by ultrasound, Blood pressure was determine d by clinic measurements and by 24 h noninvasive ambulatory blood pressure monitoring. Results According to the presence of left ventricular hypertrophy (left ven tricular mass index > 50 g/m(2.7) in males and > 47 g/m(2.7) in females) or concentric left ventricular remodelling (normal left ventricular mass inde x and relative wall thickness > 0.42), the subjects were divided into four groups: 124 subjects with normal left ventricular geometry, 73 subjects wit h left ventricular hypertrophy (55 with eccentric and 18 with concentric hy pertrophy) and 26 subjects with concentric remodelling. The common carotid intima-media thickness and cross-sectional area were significantly greater in the subjects with:concentric left ventricular hypertrophy (analysis of v ariance, P< 0.05) than in those with normal left ventricular geometry. A si gnificantly higher number of plaques was observed in subjects with concentr ic and eccentric left ventricular hypertrophy. Conclusions In a general population of unselected middle-aged subjects, the presence of concentric left ventricular hypertrophy was associated with an increase in intima-media thickness and with the presence of plaque in the carotid arteries, possibly contributing to the worse prognosis observed in this group of patients. (C) Lippincott Williams & Wilkins.