title: Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: the PAMELA study.
abstract: We sought to evaluate new-onset abnormal LV (left ventricle) patterns and their correlates over a 10-year period in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study.
  
  
  
  The study included 817 patients with normal LV geometry at baseline evaluation having a readable echocardiogram at the end of follow-up. Cut-points for abnormal LV geometric patterns were derived from reference values of the healthy fraction of the Pressioni Arteriose Monitorate e Loro Associazioni population.
  
  
  
  Over a 10-year period 39% of participants progressed to abnormal LV geometric patterns as follows: LV concentric remodelling (15.2%), eccentric dilated left ventricular hypertrophy (LVH) (8.4%), concentric LVH (7.9%), eccentric nondilated LVH (6.8%), and concentric dilated LVH (0.7%). Age [odds ratio (OR): 1.039; 95% confidence interval (CI) 1.023-1.056, P < 0.0001], LV mass index (OR: 1.039; 95% CI 1.026-1.052, P < 0.0001), night-time SBP (OR: 1.024; 95% CI 1.005-1.043, P = 0.01), office SBP changes during follow-up (OR: 1.017 95% CI 1.007-1028, P = 0.001), and BMI (OR: 1.067; 95% CI 1.017-1.120, P = 0.009) emerged as key correlates of new-onset abnormal LV geometry. Age and LV mass index turned out to be strong determinants of all sub-types of LVH; whereas blood pressure, BMI, and sex exhibited a different predictive value across the various LV geometric patterns.
  
  
  
  Our study provides the first evidence that long-term changes from normal cardiac morphology toward abnormal LV geometry represent a clinically relevant phenomenon at the community level. From a practical perspective this finding reinforces the concept that life-style changes and pharmacologic treatment aimed to reduce over-weight/obesity and optimize blood pressure are of paramount importance for prevention of subclinical cardiac damage.
authors.affiliation: aDepartment of Medicine and Surgery, University of Milano-Bicocca bIstituto Auxologico Italiano IRCCS cDepartment of Clinical Sciences and Community, Health University of Milano and Fondazione Ospedale Maggiore Policlinico, Milan, Italy dUniversity Clinical Hospital Centre "Dragisa Misovic", Belgrade, Serbia eIRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013599:Systole; D020257:Ventricular Remodeling