Original Article
Relationship between Elevated Arterial Stiffness and Increased Left Ventricular Mass in Adolescents and Young Adults

https://doi.org/10.1016/j.jpeds.2010.12.020Get rights and content

Objective

To determine whether arterial stiffness relates to left ventricular mass (LVM) in adolescents and young adults.

Study design

Demographic, anthropometric, laboratory, echo, carotid ultrasound and arterial stiffness data were obtained in 670 subjects 10 to 24 years of age (35% male, 62% non-Caucasian). Global stiffness index (GSI) was calculated from five measures of carotid artery stiffness, augmentation index, brachial distensibility, and pulse wave velocity (1 point if ≥95th% for subjects with body mass index <85th%). Stiff arteries (S = 73) were defined as GSI ≥95th%. Differences between flexible (F = 597) and S groups were evaluated by t tests. Models were constructed to determine whether GSI was an independent determinant of LVM index or relative wall thickness (RWT).

Results

The S group had more adverse cardiovascular risk factors, higher LVM index and RWT (P ≤ .05) with a trend for abnormal cardiac geometry. Independent determinants of LVM index were higher GSI, age, body mass index, systolic blood pressure, heart rate, glycated hemoglobin A1c, male sex, and sex–by–heart rate interaction (r2 = 0.52; P ≤ .05). GSI was also an independent determinant of RWT.

Conclusions

Increased arterial stiffness in adolescents and young adults is associated with LVM index independently of traditional cardiovascular risk factors. Screening for arterial stiffness may be useful to identify high risk adolescents and young adults.

Section snippets

Methods

The study population consisted of 670 adolescents and young adults who participated in a study comparing cardiovascular parameters among adolescents and young adults who were lean, obese, or obese with type 2 diabetes mellitus (age 10 to 24 years, 62% non-Caucasian, 35% male, 29% with type 2 diabetes mellitus). Pregnant females were excluded from the study. Investigational review board approval was obtained, and written informed consent was obtained from subjects ≥18 years or the guardian for

Results

Subjects in the S group were 1.8 years older, more obese, and had a more adverse lipid and metabolic profile with higher levels of inflammation (Table I). They also had higher peripheral and central (aortic) BP and HR (Table II). Both LVM index and RWT were greater in subjects with higher GSI (Table II, P ≤ .05). AIx, PWV, ß, PWM, and YEM were higher and BrachD was lower in the stiff group consistent with increased arterial stiffness.

CAS was lower in the S group, suggesting lower strain.

Discussion

Our data demonstrate that higher LVM and RWT in adolescents and young adults are associated with increased arterial stiffness independently of traditional cardiovascular risk factors such as age, sex, obesity, BP, lipids, and metabolic control. There is also a trend for a higher prevalence of eccentric hypertrophy in the adolescents and young adults with stiffer arteries, which may be driven by the greater level of adiposity in the stiff artery group.

Abnormal LVM and geometry are

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    Supported by NIH, NHLBI, (R01 HL076269, CV Disease in Adolescents with Type 2 Diabetes) and USPHS (UL1 RR026314, National Center for Research Resources). The authors declare no conflicts of interest.

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