Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly: The cardiovascular health study

J. M. Gardin, D. Siscovick, H. Anton-Culver, J. C. Lynch, V. E. Smith, H. S. Klopfenstein, William J Bommer, L. Fried, D. O'Leary, T. A. Manolio

Research output: Contribution to journalArticle

206 Citations (Scopus)

Abstract

Background: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older. Methods and Results: M-mode LV mass adjusted for body weight increased modestly with age (P<.0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P<.001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34% of CHS participants, and this was highly related to age (29% in the 65 to 69 year versus 50% in the 85+ year age group, P<.001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P<.001). Of interest, 0.5% of men and 0.4% of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26% of men and 10% of women in the clinical CHD group (p<.0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P<.001) to be independent predictors of LV akinesis or dyskinesis. Conclusions: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.

Original languageEnglish (US)
Pages (from-to)1739-1748
Number of pages10
JournalCirculation
Volume91
Issue number6
StatePublished - 1995
Externally publishedYes

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Coronary Disease
Health
Heart Diseases
Hypertension
Stroke Volume
Cohort Studies
Morbidity
Weights and Measures
Mortality
Left Ventricular Hypertrophy
Sex Characteristics
Multicenter Studies
Myocardial Ischemia
Echocardiography
Multivariate Analysis
Age Groups
Body Weight

Keywords

  • aging
  • cardiovascular diseases
  • echocardiography
  • multicenter study
  • ventricles

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Gardin, J. M., Siscovick, D., Anton-Culver, H., Lynch, J. C., Smith, V. E., Klopfenstein, H. S., ... Manolio, T. A. (1995). Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly: The cardiovascular health study. Circulation, 91(6), 1739-1748.

Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly : The cardiovascular health study. / Gardin, J. M.; Siscovick, D.; Anton-Culver, H.; Lynch, J. C.; Smith, V. E.; Klopfenstein, H. S.; Bommer, William J; Fried, L.; O'Leary, D.; Manolio, T. A.

In: Circulation, Vol. 91, No. 6, 1995, p. 1739-1748.

Research output: Contribution to journalArticle

Gardin, JM, Siscovick, D, Anton-Culver, H, Lynch, JC, Smith, VE, Klopfenstein, HS, Bommer, WJ, Fried, L, O'Leary, D & Manolio, TA 1995, 'Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly: The cardiovascular health study', Circulation, vol. 91, no. 6, pp. 1739-1748.
Gardin JM, Siscovick D, Anton-Culver H, Lynch JC, Smith VE, Klopfenstein HS et al. Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly: The cardiovascular health study. Circulation. 1995;91(6):1739-1748.
Gardin, J. M. ; Siscovick, D. ; Anton-Culver, H. ; Lynch, J. C. ; Smith, V. E. ; Klopfenstein, H. S. ; Bommer, William J ; Fried, L. ; O'Leary, D. ; Manolio, T. A. / Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly : The cardiovascular health study. In: Circulation. 1995 ; Vol. 91, No. 6. pp. 1739-1748.
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abstract = "Background: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older. Methods and Results: M-mode LV mass adjusted for body weight increased modestly with age (P<.0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P<.001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34{\%} of CHS participants, and this was highly related to age (29{\%} in the 65 to 69 year versus 50{\%} in the 85+ year age group, P<.001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P<.001). Of interest, 0.5{\%} of men and 0.4{\%} of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26{\%} of men and 10{\%} of women in the clinical CHD group (p<.0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P<.001) to be independent predictors of LV akinesis or dyskinesis. Conclusions: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.",
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T1 - Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly

T2 - The cardiovascular health study

AU - Gardin, J. M.

AU - Siscovick, D.

AU - Anton-Culver, H.

AU - Lynch, J. C.

AU - Smith, V. E.

AU - Klopfenstein, H. S.

AU - Bommer, William J

AU - Fried, L.

AU - O'Leary, D.

AU - Manolio, T. A.

PY - 1995

Y1 - 1995

N2 - Background: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older. Methods and Results: M-mode LV mass adjusted for body weight increased modestly with age (P<.0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P<.001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34% of CHS participants, and this was highly related to age (29% in the 65 to 69 year versus 50% in the 85+ year age group, P<.001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P<.001). Of interest, 0.5% of men and 0.4% of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26% of men and 10% of women in the clinical CHD group (p<.0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P<.001) to be independent predictors of LV akinesis or dyskinesis. Conclusions: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.

AB - Background: Left ventricular (LV) hypertrophy, as measured by M-mode echocardiography, is an independent predictor of mortality and/or morbidity from coronary heart disease (CHD). LV global and segmental systolic dysfunction also have been associated with myocardial ischemia and cardiovascular morbidity and mortality. Echocardiographic data, especially two-dimensional, have not been available previously from multicenter-based studies of the elderly. This report describes the distribution and relation at baseline of echocardiographic LV mass and global and segmental LV wall motion to age, sex, and clinical disease category in the Cardiovascular Health Study (CHS), a cohort of 5201 men and women (4850 white) 65 years of age and older. Methods and Results: M-mode LV mass adjusted for body weight increased modestly with age (P<.0001), increasing less than one gram per year increase in age for both men and women. After adjustment for weight, LV mass was significantly greater in men than in women and in participants with clinical CHD compared with participants with neither clinical heart disease nor hypertension (both P<.001). Across all CHS age subgroups, the difference in weight-adjusted LV mass by sex was greater in magnitude than the difference related to clinical CHD. M-mode measurements of LV mass could not be made in 34% of CHS participants, and this was highly related to age (29% in the 65 to 69 year versus 50% in the 85+ year age group, P<.001) and other risk factors. In participants with clinical CHD and with neither clinical heart disease nor hypertension, LV ejection fraction and segmental wall motion abnormalities were more prevalent in men than women (all P<.001). Of interest, 0.5% of men and 0.4% of women with neither clinical heart disease nor hypertension had LV segmental wall motion abnormalities, suggesting silent disease, compared with 26% of men and 10% of women in the clinical CHD group (p<.0001). Multivariate analyses revealed male sex and presence of clinical CHD (both P<.001) to be independent predictors of LV akinesis or dyskinesis. Conclusions: Significant baseline relations were detected between differences in sex, prevalent disease status, and echocardiographic measurements of LV mass and systolic function in the CHS cohort. Age was weakly associated with LV mass measurements and LV ejection fraction abnormalities. These relations should be considered in evaluating the preclinical and clinical effects of CHD risk factors in the elderly.

KW - aging

KW - cardiovascular diseases

KW - echocardiography

KW - multicenter study

KW - ventricles

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