Left Ventricular End-Systolic Stress in Young Adults: Distribution, Risk Factors, and Relation to Cardiovascular Disease Events

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 26; no. 9; pp. 1006 - 1011
• Main Authors: Santo-Domingo, Noel E., Orlov, Michael, Wong, Nathan D., Kurosaki, Tom, Reid, Cheryl L., Hsieh, Ann-Ming Andy, Gardin, Julius M.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.10.2009
• Subjects: Adolescent; Adult; Age Distribution; cardiac ultrasound; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - ethnology; Elasticity Imaging Techniques - statistics & numerical data; Female; gender differences; Humans; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - ethnology; Incidence; left ventricle; Male; Prognosis; racial differences; Risk Assessment; Risk Factors; Stress, Mechanical; Stroke Volume; United States - epidemiology; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - ethnology; wall stress; Young Adult
• DOI: 10.1111/j.1540-8175.2009.00921.x
• ISSN: 0742-2822

Background: We examined the relationship of left ventricular (LV) end‐systolic meridional wall stress (LVESS), a measure of LV afterload, with race, gender, other cardiovascular risk factors and LV mass in 3,994 young adults in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Methods: From transthoracic echocardiography, LVESS was derived from LV internal dimension and posterior wall thickness and systolic blood pressure (BP). Results: Adjusted LVESS was significantly greater in black men versus women (59.0 vs. 54.8 dynes/cm, P < 0.01) and in white men versus women (59.0 vs. 55.4 dynes/cm2, P < 0.01), but did not differ in comparing whites versus blacks either in men or women. In multiple regression analyses, age and LV mass were inversely (P < 0.01) and height was positively (P < 0.01) associated with LVESS. The overall variance of LVESS explained by the models in each race‐sex subgroup was low (R2 less than 0.03), suggesting that standard risk factors contribute little to determining LVESS in young adults. Over a 15‐year follow‐up period, LVESS, after the adjustment for covarieties, was not associated with the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) events. Conclusion: LVESS may not be a useful marker of cardiovascular risk in young adults; further study is needed to determine whether other echocardiographic measures may be more useful predictors.