Original ArticleRelationship between Elevated Arterial Stiffness and Increased Left Ventricular Mass in 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
References (51)
- et al.
Arterial stiffness assessed by pulse wave analysis in essential hypertension: relation to 24-h blood pressure profile
Int J Cardiol
(2005) - et al.
Carotid artery stiffness in obese children with the metabolic syndrome
Am J Cardiol
(2006) - et al.
Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study
J Am Coll Cardiol
(2001) - et al.
Association of carotid atherosclerosis and left ventricular hypertrophy
JACC
(1995) - et al.
Contrasting prevalence of and demographic disparities in the World Health Organization and National Cholesterol Education Program Adult Treatment Panel III definitions of metabolic syndrome among adolescents
J Pediatr
(2004) - et al.
Brachial artery distensibility and relation to cardiovascular risk factors in healthy young adults (The Bogalusa Heart Study)
American Journal of Cardiology
(2002) - et al.
Impact of multiple cardiovascular risk factors on brachial artery distensibility in young adults: the Bogalusa Heart Study
Am J Hypertens
(2005) - et al.
Spurious systolic hypertension of youth: fit young men with elastic arteries
Am J Hypertens
(2003) - et al.
Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings
Am J Cardiol
(1986) - et al.
Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight
J Am Coll Cardiol
(1992)
A novel Doppler echocardiographic method of measuring the biophysical properties of the aorta in pediatric patients
J Am Soc Echocardiogr
The relationship of left ventricular mass and geometry to incident cardiovascular events: the MESA (Multi-Ethnic Study of Atherosclerosis) Study
J Am Coll Cardiol
Arterial distensibility and left ventricular hypertrophy in patients with sustained essential hypertension
Am Heart J
Left ventricular mass and arterial compliance: relation to coronary heart disease and its risk factors in South Indian adults
Int J Cardiol
Electrocardiographic left ventricular hypertrophy and arterial stiffness: the Ohasama study
Am J Hypertens
Regression of left ventricular mass in hypertensive patients treated with perindopril/indapamide as a first-line combination: the REASON echocardiography study
Am J Hypertens
Effect of antihypertensive monotherapy and combination therapy on arterial distensibility and left ventricular mass
Am J Hypertens
Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients
J Am Coll Cardiol
Ambulatory blood pressure, left ventricular mass, and conduit artery function late after successful repair of coarctation of the aorta
J Am Coll Cardiol
Increased central aortic stiffness and left ventricular mass in normotensive young subjects after successful coarctation repair
Am Heart J
Angular (Gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: evaluation with magnetic resonance flow mapping
J Thorac Cardiovasc Surg
Estimation of an age-specific reference interval for pulse wave velocity: a meta-analysis
J Hypertens
Assessment of aortic pulse wave velocity and cardiac diastolic function in subjects with and without the metabolic syndrome: HDL cholesterol is independently associated with cardiovascular function
Diabetes Care
Ageing induces left ventricular concentric remodelling in normotensive subjects
J Hypertens
Implications of persistent prehypertension for ageing-related changes in left ventricular geometry and function: the MONICA/KORA Augsburg study
J Hypertens
Cited by (68)
Visceral fat might impact left ventricular remodeling through changes in arterial stiffness in type 2 diabetes: A cross-sectional study
2022, International Journal of CardiologyRelationship between Arterial Stiffness and Subsequent Cardiac Structure and Function in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY Study
2022, Journal of the American Society of EchocardiographyCitation Excerpt :Prior studies in adolescents relating arterial stiffness with cardiac structure and function have been cross-sectional.12 In a similar age cohort, where data were stratified by high and normal arterial stiffness, those in the high-PWV group were more likely to have higher LV mass and LV relative wall thickness as well as higher BP, BMI, and HbA1c.5 Cross-sectional work in adults also shows higher arterial stiffness associated with adverse changes in diastolic function; however, stiffness in the brachial artery only was assessed, which may not represent stiffness in other arterial beds.15
Vascular Ageing in Youth: A Call to Action
2021, Heart Lung and CirculationYouth Vascular Consortium (YVC) Protocol: Establishing Reference Intervals for Vascular Ageing in Children, Adolescents and Young Adults
2021, Heart Lung and CirculationCitation Excerpt :Carotid to femoral pulse wave velocity (PWV) is typically the reference standard for measuring arterial stiffness. Children with increased arterial stiffness, determined by PWV, have increased left ventricular mass [16] and reduced left ventricular function [17], independent of traditional cardiovascular risk factors [16]. Increased PWV in children has also been associated with increased carotid-intima media thickness (cIMT) [18].
Bariatric Surgery and Adolescent Type 2 Diabetes
2019, Pediatric Type II Diabetes
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.