BACKGROUND Left ventricular (LV) hypertrophy is an independent risk factor for cardiovascular outcomes. There are limited data about modifiable factors associated with progression of LV hypertrophy in older adults. Our objective is to describe the changes in LV mass and geometry over time in a predominantly older multiethnic cohort and to identify possible predictors of changes over time. METHODS We analyzed data from participants in the Northern Manhattan Study who underwent serial echocardiographic studies, comparing the baseline and the most recent echocardiograms. We recorded changes in LV mass and geometry and correlated them with baseline characteristics using linear regression models. RESULTS There were 826 participants (mean age, 64.2 ± 8.0 years) included in the analysis (time between measurements, 8.5 ± 2.7 years). Overall, LV mass index increased from 45.0 ± 12.7 to 50.3 ± 14.6 g/m2.7 (P < .001). There were 548 participants (66.3%) with LV mass increase; 258 individuals (31.2%) showed worsening LV geometry. Multivariable analysis showed that change in LV mass index was independently associated with baseline LV mass index (β estimate, -17.000 [standard error, 1.508]; P < .001), hypertension (2.094 [0.816], P = .011), body mass index (0.503 [0.088], P < .001), and waist-to-hip ratio (1.031 [0.385], P = .008). Both waist-to-hip ratio and waist-to-height ratio remained significantly associated with LV mass increase even after adjusting for body mass index (P = .008 and P = .036, respectively). CONCLUSIONS Regardless of race/ethnicity, LV mass progressed over time in older adults. We also observed that worsening geometry was frequent. Assessment of central obesity in the older population is important because indicators of central obesity add prognostic value over body mass index for the risk of LV mass increase.

中文翻译：

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老年人左心室质量和几何形状的变化：体重和中枢性肥胖的作用。

背景技术左心室肥大是心血管疾病预后的独立危险因素。关于与老年人左室肥大进展有关的可调节因素的数据有限。我们的目的是描述一个主要是较老的多种族人群的左心室质量和几何形状随时间的变化，并确定随时间变化的可能预测因素。方法我们分析了北部曼哈顿研究参与者的数据，这些参与者接受了连续超声心动图研究，比较了基线和最新超声心动图。我们记录了LV质量和几何形状的变化，并使用线性回归模型将其与基线特征相关联。结果分析中包括826名参与者（平均年龄64.2±8.0岁）（两次测量之间的时间为8.5±2.7岁）。全面的，左心室质量指数从45.0±12.7增加到50.3±14.6 g / m2.7（P <.001）。左室重量增加的参与者有548名（66.3％）；258人（31.2％）表现出LV几何恶化。多变量分析表明，左室重量指数的变化与基线左室重量指数独立相关（β估计值，-17.000 [标准误差，1.508]； P <.001），高血压（2.094 [0.816]，P = .011），身体质量指数（0.503 [0.088]，P <.001）和腰臀比（1.031 [0.385]，P = .008）。即使调整了身体质量指数，腰围与臀围比例和腰围与身高比例仍与LV质量增加显着相关（分别为P = 0.008和P = .036）。结论不论种族/民族，老年人的左心室质量均会随着时间的推移而发展。我们还观察到几何形状恶化是经常发生的。