A 25-YEAR LONGITUDINAL GENDER-BASED STUDY ON LEFT VENTRICULAR GEOMETRY TRACKING IN THE GENERAL POPULATION: THE PAMELA STUDY
Cesare Cuspidi, Rita Facchetti, Marijana Tadic, Elisa Gherbesi, Giuseppe Mancia, Guido GrassiAbstract
Background
Longitudinal findings on the relationship between sex, aging and left ventricular (LV) geometric patterns in population-based cohorts with a low prevalence of risk factors, are still scarce. We investigated this issue in the participants of the third survey of Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study in which echocardiographic data were prospectively collected over a 25-year period.
Methods
420 participants who attended the initial survey (1990-1993) and two subsequent ones, 10 (2001-2003) and 25 years later (2017-2018), were included in the analysis. LV geometric patterns were defined according to American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) guidelines.
Results
The prevalence of LV concentric geometry (i.e. relative wall thickness ≥ 0.43) increased progressively across the three surveys in both men: 11.5 (CI: 7.8-16.7), 29.0 (CI: 23.1-35.6), 53.0% (CI: 46.1-59.8), p < 0.001 and women: 5.5 (CI: 3.1-9.3), 14.9 (CI: 10.5-19.8), 36.8% (CI: 30.7-43.4), p < 0.001. Contrary to what found for other patterns, the prevalence of concentric LV hypertrophy (LVH) showed a different sex-specific behaviour, i.e. a gradual increase in women from the first to the third survey: 1.4 (CI: 0.5-2.4), 5.0 (CI: 2.8-8.3), 13.6% (CI: 9.7-18.8), p < 0.001) and a decline from second to third survey in men: 0.5 (CI: 0.1-2.8), 9.0 (CI: 5.8-13.9), 7.5% (CI: 4.6-12.0), p < 0.05).
Conclusions
Our findings show that aging is accompanied by a marked increase in concentric geometry in both sexes, and suggest that women are at higher risk of developing concentric LVH.