Age, Gender and Load-Related Influences on Left Ventricular Geometric Remodeling, Systolic Mid-Wall Function, and NT-ProBNP in Asymptomatic Asian Population.
BACKGROUND
Advanced age is associated with left ventricle (LV) remodeling and impaired cardiac function that may increase the risk of heart failure. Even so, studies regarding age-related cardiac remodeling in a large, asymptomatic Asian population remain limited.


METHODS
We studied 8,410 asymptomatic participants (49.7 ±11.7 y, 38.9% women) in a health evaluation cohort (2004-2012) at a tertiary center in Northern Taiwan. We analyzed age-related alterations for all echocardiography-derived cardiac structures/functions and the associations with circulating N-terminal prohormone of brain natriuretic peptide (NT-proBNP). We also explored sex-related differences in these measures.


RESULTS
In our cohort of 8,410 participants, advanced age was associated with greater LV wall thickness, larger LV total mass (+5.08 g/decade), and greater LV mass index (4.41 g/m2/decade), as well as increased serum NT-proBNP level (+18.89 pg/mL/decade). An accompanying reduction of stress-corrected midwall fractional shortening (-0.1%/decade) with aging was apparent in women after multi-variate adjustment (-0.09%/decade, p = 0.001). Furthermore, women demonstrated greater overall increase in LV wall thickness, LV mass index, and NT-proBNP compared to men (p for interaction: <0.001). All blood pressure components, including systolic, diastolic, and pulse pressures were independently associated with greater wall thickness and LV mass index after adjustment for confounders (all p <0.001). The associations between age and cardiac remodeling or mid-wall functions were further confirmed in a subset of study subjects with repeated follow up by GEE model.


CONCLUSIONS
Significant associations of unfavorable LV remodeling and advanced age in our asymptomatic Asian population were observed, along with sex differences. These data may help explain the incidence of some diverse gender-related cardiovascular diseases, especially heart failure.
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
Chi
C
Chen
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei branch, Taipei City, Taiwan.
Kuo-Tzu
KT
Sung
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei branch, Taipei City, Taiwan.
Shou-Chuan
SC
Shih
The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
Chuan-Chuan
CC
Liu
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
Jen-Yuan
JY
Kuo
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei branch, Taipei City, Taiwan.
Charles Jia-Yin
CJ
Hou
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei branch, Taipei City, Taiwan.
Chung-Lieh
CL
Hung
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei branch, Taipei City, Taiwan.
Hung-I
HI
Yeh
D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012737:Sex Factors; D020257:Ventricular Remodeling / Q000502:physiology*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain