Association between risk factors and left ventricular remodeling in middle-aged and aged population:  a community-based study.
BACKGROUND
Left ventricular remodeling plays a vital role in the progression of heart failure and contributes to the clinical and symptomatic deterioration.


METHODS
We conducted a community-based, cross-sectional study in the middle-aged and geriatric population to assess various potential risk factors for predicting left ventricular enlargement (LVE) and hypertrophy (LVH). LVE was defined by indexing left ventricular internal diameter at end-diastole to height and LVH was defined in the light of calculation of left ventricular mass index. A more specific classification of left ventricular remodeling was further identified. Multiple correspondence analysis and multiple logistic regression analysis were applied.


RESULTS
Of 1914 participants, 32.3% were men and average age was 59.5 ± 8.9 years. Statistical analysis indicated that BMI [odds ratio (OR) 1.255, 95% confidence interval (CI) 1.191-1.322], central blood pressure (CBP; OR 1.016, 95% CI 1.008-1.024), radial augmentation index (radial AI; OR 1.014, 95% CI 1.0001-1028), and B-type natriuretic peptide (BNP; OR 1.001, 95% CI 1.0003-1.002) were independently related to LVE, whereas BMI (OR 1.301, 95% CI 1.232-1.374), CBP (OR 1.020, 95% CI 1.012-1.029), and BNP (OR 1.002, 95% CI 1.001-1.003) showed a strong association with LVH. However, radial AI failed to be predictive for any specific patterns of remodeling. BMI, CBP, and BNP were demonstrated to be associated with all other patterns except concentric remodeling, although BNP had no significant correlation with eccentric remodeling. Serum high-sensitivity C-reactive protein and homocysteine were not predictive for remodeling.


CONCLUSIONS
Our findings limited the utility of augmentation index as an early predictor for left ventricular remodeling, whereas BMI, CBP, and BNP probably were independently robust predictors.
Heart, Lung and Blood Vessel Center, Tongji University School of Medicine, Shanghai, China.
Lezhou
L
Wu
Lijuan
L
Zhang
Zisheng
Z
Ai
Liling
L
Zou
Yun
Y
Zhu
Yan
Y
Bao
Jun
J
Li
Sheng
S
Kang
Huimin
H
Fan
Daifu
D
Zhang
Lieying
L
Fan
Zhongmin
Z
Liu
Jue
J
Li
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D020257:Ventricular Remodeling