WHICH ARTERIAL AND CARDIAC PARAMETERS BEST PREDICT LEFT-VENTRICULAR MASS

Background-Many cardiovascular and noncardiovascular parameters are th ought to be determinants of left ventricular mass (LVM). Complicated i nteractions necessitate the simultaneous measurement and consideration of each to determine their individual and collective impact on LVM. W e undertook such a comprehensive study. Methods and Results-Tne influe nce of anthropometry, cardiac size and contractility, arterial structu re and function, as well as indices of lifestyle, physical activity, a nd dietary salt intake on LVM (by two-dimensionally guided M-mode echo cardiography) was analyzed in 1315 Chinese subjects who were either no rmotensive or had untreated hypertension. Effects of many cardiac and arterial factors were assessed. In univariate analysis, almost all mea sured noncardiovascular, cardiac, and arterial variables were signific antly correlated with LVM. In multivariate linear regression analyses, when age, sex, body habitus, fasting serum C-peptide level, dietary s alt, physical activity, and lifestyle were accounted for, the optimum multivariate linear regression main effects model had an adjusted mode l r(2) of 0.740, with 98% of the model variance accounted for by the 5 independent determinants of LVM: stroke volume (49.6%), systolic bloo d pressure (30.7%), contractility (14.7%), body mass index (1.8%), and aortic root diameter (1.6%). Other proposed arterial indices were sig nificant independent determinants of LVM only when blood pressure was removed from the model and, even then, these indices not only resulted in less powerful prediction but also accounted for only a very small percentage of the total variance of LVM. Conclusions-In a large popula tion, we (1) confirmed that age, body habitus, and some indexes of art erial structure and function are independent determinants of LVM; (2) found aortic diameter to be an independent structural determinant of L VM; (3) demonstrated that the effects of the derived measures of arter ial function were small and provided no better predictive power than b lood pressure alone; and (4) showed that when the best measures of car diac and vascular load were included, the single most potent predictor was an index of left ventricular size.