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Left Ventricular End‐Systolic Stress in Young Adults: Distribution, Risk Factors, and Relation to Cardiovascular Disease Events
Author(s) -
SantoDomingo Noel E.,
Orlov Michael,
Wong Nathan D.,
Kurosaki Tom,
Reid Cheryl L.,
Hsieh AnnMing Andy,
Gardin Julius M.
Publication year - 2009
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2009.00921.x
Subject(s) - medicine , cardiology , blood pressure , coronary artery disease , risk factor
Background: We examined the relationship of left ventricular (LV) end‐systolic meridional wall stress (LVESS), a measure of LV afterload, with race, gender, other cardiovascular risk factors and LV mass in 3,994 young adults in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: From transthoracic echocardiography, LVESS was derived from LV internal dimension and posterior wall thickness and systolic blood pressure (BP). Results: Adjusted LVESS was significantly greater in black men versus women (59.0 vs. 54.8 dynes/cm, P < 0.01) and in white men versus women (59.0 vs. 55.4 dynes/cm 2 , P < 0.01), but did not differ in comparing whites versus blacks either in men or women. In multiple regression analyses, age and LV mass were inversely (P < 0.01) and height was positively (P < 0.01) associated with LVESS. The overall variance of LVESS explained by the models in each race‐sex subgroup was low (R 2 less than 0.03), suggesting that standard risk factors contribute little to determining LVESS in young adults. Over a 15‐year follow‐up period, LVESS, after the adjustment for covarieties, was not associated with the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) events. Conclusion: LVESS may not be a useful marker of cardiovascular risk in young adults; further study is needed to determine whether other echocardiographic measures may be more useful predictors.