Impaired flow-mediated vasodilatation is associated with increased left ventricular mass in a multiethnic population. The Northern Manhattan Study.
BACKGROUND
Increased left ventricular (LV) mass and endothelial dysfunction are important risk factors for cardiovascular mortality and morbidity. However, it is not clear whether endothelial dysfunction is associated with increased LV mass. We tested the hypothesis that impaired flow-mediated vasodilatation (FMD) is associated with increased LV mass in a population-based multiethnic cohort.


METHODS
As a part of the Northern Manhattan Study (NOMAS), we performed two-dimensional echocardiography and FMD assessment during reactive hyperemia by high-resolution ultrasonography in 867 stroke-free community participants. LV mass was calculated according to an established method. LV hypertrophy was defined as the 90th percentile of sex-specific LV mass indexed for body surface area among normal subjects. Multivariable models were used to test the association of FMD with LV mass.


RESULTS
In multiple linear regression analysis adjusting for age, sex, body mass index, systolic blood pressure, antihypertensive medications, low-density lipoprotein cholesterol, diabetes, smoking, hematocrit, and race-ethnicity, FMD was inversely associated with LV mass (beta = -1.21 +/- 0.56, P = 0.03). The association persisted after further adjustment for any component of blood pressure (systolic, mean, and pulse pressure). In univariate logistic regression analysis, each 1% decrease in FMD was associated with an 8% higher risk of LV hypertrophy (odds ratio 1.08, 95% confidence interval 1.03-1.13 per each FMD point P < 0.01).


CONCLUSIONS
Impaired FMD is associated with LV mass, independent of other factors associated with increased LV mass. Endothelial dysfunction might be a potential risk factor for LV hypertrophy.
Hasegawa
Takuya
T
Division of Cardiology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Boden-Albala
Bernadette
B
Eguchi
Kazuo
K
Jin
Zhezhen
Z
Sacco
Ralph L
RL
Homma
Shunichi
S
Di Tullio
Marco R
MR
D000368:Aged; D015331:Cohort Studies; D003710:Demography; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000502:physiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014463:Ultrasonography; D014664:Vasodilation; D020257:Ventricular Remodeling