title: Left ventricular geometric patterns in the Jackson cohort of the Atherosclerotic Risk in Communities (ARIC) Study: clinical correlates and influences on systolic and diastolic dysfunction.
abstract: BACKGROUND
  The distribution and determinants of left ventricular (LV) geometric patterns and their relation to LV function in African Americans is not well described despite higher rates of LV hypertrophy and cardiovascular mortality reported in this group.
  
  
  OBJECTIVE
  This study investigates the distribution and clinical correlates of LV geometric patterns and how these patterns relate to function in a population-based African American cohort.
  
  
  METHODS
  The study population included participants in the Jackson cohort of ARIC, who underwent echocardiograms between 1993 and 1995. We defined 4 geometric patterns (normal geometry, concentric remodeling [CR], eccentric hypertrophy [EH], and concentric hypertrophy [CH]) according to LV mass index and relative wall thickness. Multiple logistic regression was used to assess the association of geometric patterns to systolic dysfunction and diastolic dysfunction, adjusting for traditional coronary risk factors.
  
  
  RESULTS
  There were 1849 participants in the study population (mean age 59 years, 65% women). Concentric remodeling and CH were highly prevalent. Concentric hypertrophy and EH groups had the highest rates of hypertension, obesity, and diabetes mellitus. Compared to the normal geometric pattern, EH was related to systolic dysfunction (OR 24.27, CI 6.71-87.80), and CH was related to diastolic dysfunction 1.58 (1.04-2.39). Concentric remodeling was not related to systolic or diastolic dysfunction.
  
  
  CONCLUSIONS
  In this large middle-aged African American cohort, CR and CH are prevalent. Hypertension, diabetes mellitus, and obesity are associated with both CH and EH. Concentric hypertrophy is strongly associated with diastolic dysfunction; EH is strongly associated with systolic dysfunction. Concentric remodeling, however, is not related to either systolic or diastolic dysfunction.
authors.affiliation: The NHLBI's Jackson Heart Study, Jackson, MS 39216, USA. efox@medicine.umsmed.edu
authors.forename: Ervin R
authors.initials: ER
authors.lastname: Fox
authors.forename: Jason
authors.initials: J
authors.lastname: Taylor
authors.forename: Herman
authors.initials: H
authors.lastname: Taylor
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.forename: Tandaw
authors.initials: T
authors.lastname: Samdarshi
authors.forename: Donna
authors.initials: D
authors.lastname: Arnett
authors.forename: Merle
authors.initials: M
authors.lastname: Myerson
mesh_terms: D001741:Black or African American; D050197:Atherosclerosis; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D016276:Ventricular Function