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(Hypertension. 1999;34:1026-1031.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Hemodynamic Function at Rest, During Acute Stress, and in the Field

Predictors of Cardiac Structure and Function 2 Years Later in Youth

Gaston K. Kapuku; Frank A. Treiber; Harry C. Davis; Gregory A. Harshfield; Barton B. Cook; George A. Mensah

From the Georgia Prevention Institute (G.K.K., F.A.T., H.C.D., G.A.H., G.A.M.), Departments of Medicine (G.A.M.), Pediatrics (F.A.T., G.A.H., B.B.C.), and Psychiatry (F.A.T.), and Office of Biostatistics (H.C.D.), Medical College of Georgia, Augusta.

Correspondence to Frank A. Treiber, PhD, Medical College of Georgia, Georgia Prevention Institute, HS-1640, Augusta, GA 30912-3710. E-mail ftreiber{at}mail.mcg.edu

Abstract—Left ventricular hypertrophy is an independent predictor of cardiovascular morbidity and mortality. However, predictors of cardiac structure and function in youth are not completely understood. On 2 occasions (2.3 years apart), we examined 146 youth aged initially 10 to 19 years (mean age, 14.2±1.8 years). On the initial visit, hemodynamic function was assessed at rest, during laboratory stress (ie, orthostasis, car-driving simulation, video game, and forehead cold), and in the field (ie, ambulatory blood pressure). Quantitative M-mode echocardiograms were obtained on both visits. On both visits, black compared with white youth had higher resting laboratory systolic blood pressure (P<0.02), greater relative wall thickness (P<0.003), greater left ventricular mass indexed by either body surface area or height^2.7 (P<0.01 for both), and lower midwall fractional shortening ratio (P<0.05). Hierarchical stepwise regression analysis indicated that significant independent predictors of follow-up left ventricular mass/height^2.7 were the initial evaluation of left ventricular mass/height^2.7, body mass index, gender (males more than females), and supine resting total peripheral resistance (final model R²=0.53). Left ventricular mass/body surface area was predicted by initial left ventricular mass/body surface area, weight, gender, mean supine resting total peripheral resistance, and systolic pressure response to car-driving simulation (final model R²=0.48). Midwall fractional shortening was predicted by initial midwall fractional shortening, race (white more than black), and lower mean supine total peripheral resistance (final model R²=0.13). The clinical significance of these findings and their implications for improved prevention of cardiovascular diseases are yet to be determined.

Key Words: blood pressure • left ventricular mass • ventricular function • youth

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