BACKGROUND: Left ventricular hypertrophy (LVH) defined by either ECG or echocardiographic criteria is a risk factor for cardiovascular morbidity and mortality. A number of determinants of LVH have been described in previous studies, principally male sex, hypertension, obesity, and aortic valvular stenosis. We examined the distribution of LV mass (LVM) in a population of 18- to 42-year-old normotensive men and women who were free of valvular heart disease to establish sex-specific normal values for LVM index (LVMI) and to determine the correlates of LVMI. METHODS AND RESULTS: LVM was derived from measurements obtained by M-mode echocardiography. Average LVMI is significantly greater in men (102.9 +/- 0.7 g/m2) than women (88.2 +/- 0.7 g/m2). By defining LVH as an LVMI greater than the 90th percentile, we developed sex-specific criteria for LVH: men, > 125.4 g/m2; women, > 110 g/m2. We found that LVH in men is associated with indices of enhanced sympathetic nervous system reactivity and with elevated fasting insulin and triglyceride levels, which may be caused by insulin resistance. In women, LVH was associated with higher body weight and obesity. CONCLUSIONS: Before the onset of hypertension, increased LVMI appears to have different determinants in men and women. We suggest that early LVH in young men is a manifestation of hyperkinetic borderline hypertension, a state previously shown to be associated with increased sympathetic nervous system activity and insulin resistance. The hyperkinetic state is less prevalent in young women, in whom increased adiposity seems to be the predominant factor associated with LVH.
BACKGROUND:Left ventricular hypertrophy (LVH) defined by either ECG or echocardiographic criteria is a risk factor for cardiovascular morbidity and mortality. A number of determinants of LVH have been described in previous studies, principally male sex, hypertension, obesity, and aortic valvular stenosis. We examined the distribution of LV mass (LVM) in a population of 18- to 42-year-old normotensive men and women who were free of valvular heart disease to establish sex-specific normal values for LVM index (LVMI) and to determine the correlates of LVMI. METHODS AND RESULTS: LVM was derived from measurements obtained by M-mode echocardiography. Average LVMI is significantly greater in men (102.9 +/- 0.7 g/m2) than women (88.2 +/- 0.7 g/m2). By defining LVH as an LVMI greater than the 90th percentile, we developed sex-specific criteria for LVH: men, > 125.4 g/m2; women, > 110 g/m2. We found that LVH in men is associated with indices of enhanced sympathetic nervous system reactivity and with elevated fasting insulin and triglyceride levels, which may be caused by insulin resistance. In women, LVH was associated with higher body weight and obesity. CONCLUSIONS: Before the onset of hypertension, increased LVMI appears to have different determinants in men and women. We suggest that early LVH in young men is a manifestation of hyperkinetic borderline hypertension, a state previously shown to be associated with increased sympathetic nervous system activity and insulin resistance. The hyperkinetic state is less prevalent in young women, in whom increased adiposity seems to be the predominant factor associated with LVH.
Authors: Octávio Barbosa Neto; Gustavo Ribeiro da Mota; Carla Cristina De Sordi; Elisabete Aparecida M R Resende; Luiz Antônio P R Resende; Marco Antônio Vieira da Silva; Moacir Marocolo; Rafael Silva Côrtes; Lucas Felipe de Oliveira; Valdo José Dias da Silva Journal: Clin Auton Res Date: 2017-10-10 Impact factor: 4.435
Authors: Paolo Di Giosia; Paolo Giorgini; Cosimo Andrea Stamerra; Marco Petrarca; Claudio Ferri; Amirhossein Sahebkar Journal: Curr Atheroscler Rep Date: 2018-02-14 Impact factor: 5.113
Authors: Takuya Hasegawa; Bernadette Boden-Albala; Kazuo Eguchi; Zhezhen Jin; Ralph L Sacco; Shunichi Homma; Marco R Di Tullio Journal: Am J Hypertens Date: 2010-01-07 Impact factor: 2.689
Authors: Wolfgang Lieb; Vanessa Xanthakis; Lisa M Sullivan; Jayashri Aragam; Michael J Pencina; Martin G Larson; Emelia J Benjamin; Ramachandran S Vasan Journal: Circulation Date: 2009-06-08 Impact factor: 29.690