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. Author manuscript; available in PMC: 2022 Apr 1.
Published in final edited form as: J Am Soc Echocardiogr. 2020 Nov 17;34(4):388–400. doi: 10.1016/j.echo.2020.11.002

Table 3.

Associations of Significant Baseline Left Ventricular Parameters with Incident Left Ventricular Adverse Geometry*, Ejection Fraction <50%, or Diastolic Dysfunction 25 Years Later, Adjusted§ for Demographics and Cumulative Risk Factor Burden: the Coronary Artery Risk Development in Young Adults Study

Baseline LV Parameter, per 1 SD|| Adjusted§ Odds Ratio (95% Confidence Interval) for Outcome at 25-Year Follow-Up
Concentric Remodeling Concentric Hypertrophy Eccentric Hypertrophy Ejection Fraction <50% Diastolic Dysfunction
Model 1 Model 2 Model 1 Model 2 Model 1 Model 2 Model 1 Model 2 Model 1 Model 2
Outcome N (%)/total N 264 (18) / 1445 66 (5) / 1445 72 (5) / 1445 50 (3) / 1613 137 (13) / 1073
ESD/ht 0.68 (0.58–0.80) 0.68 (0.58–0.79) 0.69 (0.53–0.92) 0.69 (0.51–0.91) 1.29 (1.00–1.67) 1.34 (1.02–1.75) 2.54 (1.86–3.46) 2.56 (1.87–3.52) 0.96 (0.79–1.16) 0.97 (0.80–1.19)
Mass/ht2.7 1.06 (0.91–1.24) 1.03 (0.87–1.21) 2.10 (1.58–2.79) 1.63 (1.19–2.24) 2.24 (1.70–2.97) 1.70 (1.25–2.32) 0.83 (0.60–1.14) 0.77 (0.54–1.10) 1.42 (1.18–1.70) 1.24 (1.01–1.52)

Baseline LV variables were selected for inclusion on the basis of statistically significant univariate associations, potential for collinearity, and clinical relevance.

*

LV geometry is a polytomous outcome including: concentric remodeling, defined as RWT≥0.42 without hypertrophy; hypertrophy, defined as LVM/ht2.7 >51 g/m2.7 and classified as concentric if RWT≥0.42 and eccentric if RWT<0.42, or normal geometry.

Ejection fraction was measured by 2-dimensional imaging in 780 participants; it was measured by M-mode in 834 participants without a 2-dimensional measurement available.

Diastolic dysfunction is defined as more than half of available indicators abnormal from e’, E/e’, left atrial size, and tricuspid regurgitation jet velocity; see text (Methods) for details.

§

Model 1 adjusts for demographics (age, sex, race, educational level) and heart rate at 25-year follow-up. Model 2 additionally adjusts for cumulative clinical risk factor burden from baseline to 20 years later (sum of years at level * level of body mass index, systolic blood pressure, total to high-density lipoprotein cholesterol ratio, blood glucose, physical activity, and alcohol intake; and percent of study visits using blood pressure and cholesterol medication).

||

1 SD for ESD/ht and mass/ht2.7 respectively equals 0.22 cm/m and 7.2 grams/m2.7 for geometry outcomes, 0.22 cm/m and 8.8 grams/m2.7 for ejection fraction outcome, and 0.21 cm/m and 7.8 grams/m2.7 for diastolic dysfunction outcome.

Ns shown are for complete cases analyzed in both Model 1 and Model 2.

E, early diastolic mitral inflow velocity; e’, tissue Doppler myocardial relaxation velocity; ESD, end-systolic dimension; ht, height (meters); LV, left ventricular; M, mass; RWT, relative wall thickness; SD, standard deviation.