TY - JOUR
T1 - Hemodynamic function at rest, during acute stress, and in the field
T2 - Predictors of cardiac structure and function 2 years later in youth
AU - Kapuku, Gaston K.
AU - Treiber, Frank A.
AU - Davis, Harry C.
AU - Harshfield, Gregory A.
AU - Cook, Barton B.
AU - Mensah, George A.
PY - 1999/11
Y1 - 1999/11
N2 - Left ventricular hypertrophy is an independent predictor of cardiovascular morbidity and mortality. However, predictors of cardiac structure and function in youth are not completely understood. On 2 occasions (2.3 years apart), we examined 146 youth aged initially 10 to 19 years (mean age, 14.2 ± 1.8 years). On the initial visit, hemodynamic function was assessed at rest, during laboratory stress (ie, orthostasis, car-driving simulation, video game, and forehead cold), and in the field (ie, ambulatory blood pressure). Quantitative M-mode echocardiograms were obtained on both visits. On both visits, black compared with white youth had higher resting laboratory systolic blood pressure (P<0.02), greater relative wall thickness (P<0.003), greater left ventricular mass indexed by either body surface area or height2.7 (P<0.01 for both), and lower midwall fractional shortening ratio (P<0.05). Hierarchical stepwise regression analysis indicated that significant independent predictors of follow-up left ventricular mass/height2.7 were the initial evaluation of left ventricular mass/height2.7, body mass index, gender (males more than females), and supine resting total peripheral resistance (final model R2=0.53). Left ventricular mass/body surface area was predicted by initial left ventricular mass/body surface area, weight, gender, mean supine resting total peripheral resistance, and systolic pressure response to car-driving simulation (final model R2=0.48). Midwall fractional shortening was predicted by initial midwall fractional shortening, race (white more than black), and lower mean supine total peripheral resistance (final model R2=0.13). The clinical significance of these findings and their implications for improved prevention of cardiovascular diseases are yet to be determined.
AB - Left ventricular hypertrophy is an independent predictor of cardiovascular morbidity and mortality. However, predictors of cardiac structure and function in youth are not completely understood. On 2 occasions (2.3 years apart), we examined 146 youth aged initially 10 to 19 years (mean age, 14.2 ± 1.8 years). On the initial visit, hemodynamic function was assessed at rest, during laboratory stress (ie, orthostasis, car-driving simulation, video game, and forehead cold), and in the field (ie, ambulatory blood pressure). Quantitative M-mode echocardiograms were obtained on both visits. On both visits, black compared with white youth had higher resting laboratory systolic blood pressure (P<0.02), greater relative wall thickness (P<0.003), greater left ventricular mass indexed by either body surface area or height2.7 (P<0.01 for both), and lower midwall fractional shortening ratio (P<0.05). Hierarchical stepwise regression analysis indicated that significant independent predictors of follow-up left ventricular mass/height2.7 were the initial evaluation of left ventricular mass/height2.7, body mass index, gender (males more than females), and supine resting total peripheral resistance (final model R2=0.53). Left ventricular mass/body surface area was predicted by initial left ventricular mass/body surface area, weight, gender, mean supine resting total peripheral resistance, and systolic pressure response to car-driving simulation (final model R2=0.48). Midwall fractional shortening was predicted by initial midwall fractional shortening, race (white more than black), and lower mean supine total peripheral resistance (final model R2=0.13). The clinical significance of these findings and their implications for improved prevention of cardiovascular diseases are yet to be determined.
KW - Blood pressure
KW - Left ventricular mass
KW - Ventricular function
KW - Youth
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U2 - 10.1161/01.HYP.34.5.1026
DO - 10.1161/01.HYP.34.5.1026
M3 - Article
C2 - 10567177
AN - SCOPUS:0032733101
SN - 0194-911X
VL - 34
SP - 1026
EP - 1031
JO - Hypertension
JF - Hypertension
IS - 5
ER -