Clinical Correlates and Prognostic Significance of Change in Standardized Left Ventricular Mass in a Community‐Based Cohort of African Americans

Abstract

Background Though left ventricular mass ( LVM ) predicts cardiovascular events ( CVD ) and mortality in African Americans, limited data exists on factors contributing to change in LVM and its prognostic significance. We hypothesized that baseline blood pressure ( BP ) and body mass index ( BMI ) and change in these variables over time are associated with longitudinal increases in LVM and that such increase is associated with greater incidence of CVD . Methods and Results We investigated the clinical correlates of change in standardized logarithmically transformed‐ LVM indexed to height2.7 (log‐ LVMI ) and its association with incident CVD in 606 African Americans (mean age 58±6 years, 66% women) who attended serial examinations 8 years apart. Log‐ LVMI and clinical covariates were standardized within sex to obtain z scores for both visits. Standardized log‐ LVMI was modeled using linear regression (correlates of change in standardized log‐ LVMI ) and Cox proportional hazards regression (incidence of CVD [defined as coronary heart disease, stroke, heart failure and intermittent claudication]). Baseline clinical correlates (standardized log‐ LVM , BMI , systolic BP ) and change in systolic BP over time were significantly associated with 8‐year change in standardized log‐ LVMI . In prospective analysis, change in standardized LVM was significantly (P=0.0011) associated with incident CVD (hazards ratio per unit standard deviation change log‐ LVMI 1.51, 95% CI 1.18 to 1.93). Conclusions In our community‐based sample of African Americans, baseline BMI and BP , and change in BP on follow‐up were key determinants of increase in standardized log‐ LVMI , which in turn carried an adverse prognosis, underscoring the need for greater control of BP and weight in this group.