LEFT-VENTRICULAR MASS IN THE ELDERLY - THE CARDIOVASCULAR HEALTH STUDY

Left ventricular (LV) mass, as estimated from M-mode echocardiography (echo), has previously been shown to be an independent predictor of in cident cardiovascular disease morbidity and mortality. We evaluated th e relationship at baseline of echo LV mass to relevant cardiovascular disease risk factors and other potential covariates in the Cardiovascu lar Health Study, multicenter study sponsored by the National Heart, L ung, and Blood Institute of 5201 men and women aged 65 years or older (mean, 73). Two-dimensionally directed M-mode echo LV mass measurement s could be obtained in 1357 men and 2053 women (66% of this elderly co hort). Stepwise linear regression analyses of the relationship of echo LV mass to demographic and risk factor, physical activity, electrocar diographic, and prevalent disease variables resulted in a model that e xplained 37% of the variance for the entire cohort. In order of decrea sing importance, factors positively associated with echo LV mass were body weight, male sex, systolic pressure, presence of congestive heart failure, present smoking, major and minor electrocardiographic abnorm alities, treatment for hypertension, valvular heart disease, aortic re gurgitation by color Doppler, and mitral regurgitation by color Dopple r (in men) whereas diastolic pressure, bioresistance (a measure of adi posity), and high-density lipoprotein cholesterol were inversely relat ed to echo LV mass. Although height and weight were both related to LV mass, height added nothing once weight was entered in multiple linear regression analyses. Furthermore, in the multiple regression models, diastolic pressure was inversely and systolic BP positively related to LV mass, with similar magnitudes for their coefficients. In consonanc e with these findings, pulse pressure was positively related to LV mas s in bivariate analyses. Multiple linear regression analyses explained less of the variance for ventricular septal thickness (R-2=.13) and L V posterior wall thickness (R-2=.14) than for LV mass (R-2=.37) and LV diastolic dimension (R-2=.27). Intriguing findings in the elderly Car diovascular Health Study cohort included the presence of pulse pressur e as a positive correlate, and high-density lipoprotein cholesterol as an inverse correlate, of LV mass. Longitudinal studies in the Cardiov ascular Health Study cohort will help to clarify the importance of dem ographic, risk factor, and other variables, and changes in these varia bles, in predicting changes in echo LV mass and its components as well as the prognostic significance of LV mass in the elderly.