Introduction
Methods
Study population
Baseline clinical information
Echocardiography
Conventional echocardiography
Two-dimensional speckle-tracking echocardiography
Statistical analysis
Results
Baseline characteristics of all included study participants and stratified by sex
N | Total | Women | Men | P | |
---|---|---|---|---|---|
1297 | N = 1297 | N = 817 | N = 480 | ||
Demographics and clinical characteristics | |||||
Age, years | 1297 | 44 (32–56) | 46 (32–57) | 43 (32–55) | 0.16 |
Systolic blood pressure, mmHg | 1297 | 124 (116–131) | 121 (113–128) | 128 (121–133) | < 0.001 |
Diastolic blood pressure, mmHg | 1297 | 74 (69–79) | 74 (68–79) | 75 (70–79) | 0.002 |
Heart rate, bpm | 1277 | 63 (10) | 63 (10) | 61 (10) | < 0.001 |
BMI, kg/m2 | 1297 | 24 (3) | 23 (3) | 24 (3) | < 0.001 |
BSA, m2 | 1297 | 1.83 (0.19) | 1.74 (0.15) | 1.99 (0.15) | < 0.001 |
Smoking status | 1239 | 0.12 | |||
Never | 577 (46.6%) | 361 (46.4%) | 216 (46.9%) | ||
Previous | 446 (36.0%) | 293 (37.7%) | 153 (33.2%) | ||
Active | 216 (17.4%) | 124 (15.9%) | 92 (20.0%) | ||
Physical activity in leisure time | 1289 | < 0.001 | |||
Sedentary, n (%) | 53 (4.1%) | 36 (4.4%) | 17 (3.6%) | ||
Low, n (%) | 396 (30.7%) | 267 (32.8%) | 129 (27.2%) | ||
Moderate, n (%) | 681 (52.8%) | 449 (55.2%) | 232 (48.8%) | ||
High, n (%) | 159 (12.3%) | 62 (7.6%) | 97 (20.4%) | ||
Laboratory work | |||||
Total cholesterol, mmol/L | 1265 | 5.2 (1.1) | 5.2 (1.1) | 5.1 (1.0) | 0.090 |
LDL cholesterol, mmol/L | 1265 | 2.9 (0.9) | 2.9 (0.9) | 3.0 (0.9) | 0.023 |
HDL cholesterol, mmol/L | 1265 | 1.6 (0.5) | 1.8 (0.5) | 1.4 (0.4) | < 0.001 |
Glucose, mmol/L | 1260 | 5.1 (0.8) | 5.1 (0.7) | 5.2 (1.0) | < 0.001 |
Creatinine, umol/L | 1256 | 74.4 (11.1) | 70.0 (9.1) | 81.5 (10.4) | < 0.001 |
Haemoglobin, mmol/L | 1281 | 8.7 (0.7) | 8.4 (0.6) | 9.2 (0.6) | < 0.001 |
Echocardiography | |||||
LVEDV, mL | 1277 | 109.3 (27.6) | 96.7 (18.8) | 130.8 (26.9) | < 0.001 |
LVESV, mL | 1277 | 45.5 (12.7) | 39.5 (8.5) | 55.6 (12.3) | < 0.001 |
LVSV, mL | 1277 | 63.9 (16.4) | 57.2 (12.0) | 75.2 (16.7) | < 0.001 |
LVEF, % | 1235 | 59 (4) | 59 (4) | 58 (4) | < 0.001 |
GLS, % | 1278 | -20.6 (1.9) | -21.1 (1.8) | -19.6 (1.8) | < 0.001 |
LVMI, g/m2 | 1283 | 79.6 (16.5) | 74.0 (13.9) | 89.1 (16.2) | < 0.001 |
LAVI, mL/m2 | 1293 | 23.6 (6.9) | 23.1 (6.7) | 24.4 (7.2) | 0.001 |
E/A | 1267 | 1.4 (1.1–1.9) | 1.5 (1.1–1.9) | 1.4 (1.1–1.8) | 0.035 |
E/e’ (average) | 1259 | 5.9 (5.1–7.1) | 6.1 (5.2–7.4) | 5.6 (4.8–6.6) | < 0.001 |
DT, ms | 1266 | 187.6 (38.3) | 185.1 (37.6) | 191.9 (39.2) | 0.002 |
TAPSE, mm | 1260 | 27.0 (4.0) | 26.5 (3.9) | 27.9 (4.1) | < 0.001 |
RV S’, m/s | 1246 | 0.14 (0.02) | 0.14 (0.02) | 0.15 (0.02) | < 0.001 |
FAC, % | 1189 | 35.1 (8.3) | 35.9 (8.2) | 33.8 (8.4) | < 0.001 |
TR velocity, m/s | 757 | − 2.19 (0.23) | − 2.17 (0.22) | − 2.22 (0.24) | 0.011 |
RVSP, mmHG | 757 | 25.0 (5.4) | 24.6 (5.3) | 25.7 (5.6) | 0.016 |
Normal values of RVFWLS and RV4CLS according to sex and age
Age range, years | All | 21–39 | 40–59 | ≥ 60 | P for trend |
---|---|---|---|---|---|
Entire healthy study population | N = 1297 | N = 548 | N = 500 | N = 288 | |
RVFWLS, % SD (PI) | − 26.7 ± 5.2 (− 36.9, − 16.5) | − 27.0 ± 5.3 (− 37.1, − 16.6) | − 26.8 ± 4.9 (− 36.2, − 17.3) | − 25.9 ± 5.6 (− 36.6, − 14.3) | 0.008 |
RV4CLS, % SD (PI) | − 21.7 ± 3.4 (− 28.4, − 15.0) | − 21.8 ± 3.4 (− 28.5, − 14.8) | − 21.7 ± 3.3 (− 27.9, − 15.3) | − 21.3 ± 3.6 (− 28.4, − 14.2) | 0.07 |
Women | N = 817 | N = 336 | N = 310 | N = 171 | |
RVFWLS, % SD (PI) | − 27.5 ± 5.5* (− 38.1, − 16.7) | − 27.9 ± 5.5* (− 38.7, − 17.0) | − 27.6 ± 5.1* (− 37.5, − 17.6) | − 26.5 ± 5.9* (− 38.0, − 14.9) | 0.008 |
RV4CLS, % SD (PI) | − 22.3 ± 3.5* (− 29.2, − 15.4) | − 22.5 ± 3.4* (− 29.3, − 15.8) | − 22.4 ± 3.4* (− 29.0, -15.8) | − 21.8 ± 3.8* (− 29.3, − 14.3) | 0.049 |
Men | N = 480 | N = 212 | N = 190 | N = 78 | |
RVFWLS, % SD (PI) | − 25.4 ± 4.5* (− 34.2, − 16.6) | − 25.6 ± 4.5* (− 34.4, − 16.8) | − 25.5 ± 4.3* (− 34.0, − 17.0) | − 24.6 ± 4.7* (− 33.8, − 15.4) | 0.15 |
RV4CLS, % SD (PI) | − 20.6 ± 3.0* (− 26.4, − 14.8) | − 20.7 ± 3.0* (− 26.6, − 14.9) | − 20.6 ± 2.9* (− 26.3, − 14.9) | − 20.3 ± 2.9* (− 26.0, − 14.5) | 0.25 |
Univariable | Multivariable* | |||
---|---|---|---|---|
Standardised ß-coefficient | P | Standardised ß-coefficient | P | |
Clinical parameters | ||||
Age, years | − 0.07 | 0.009 | − 0.04 | 0.28 |
Systolic blood pressure, mmHg | − 0.12 | < 0.001 | − 0.02 | 0.65 |
BMI, kg/m2 | − 0.21 | < 0.001 | − 0.14 | < 0.001 |
Total cholesterol, mmol/L | − 0.09 | 0.001 | − 0.04 | 0.34 |
Heart rate, bpm | − 0.05 | 0.06 | 0.02 | 0.68 |
Echocardiographic parameters | ||||
LVEF, % | 0.17 | < 0.001 | 0.13 | 0.001 |
GLS, % | 0.29 | < 0.001 | 0.21 | < 0.001 |
LVMI, g/m2 | − 0.05 | 0.05 | 0.06 | 0.13 |
LAVI, mL/m2 | 0.06 | 0.046 | 0.07 | 0.06 |
E/A | 0.13 | < 0.001 | 0.08 | 0.16 |
E/e’ | − 0.02 | 0.46 | − 0.07 | 0.16 |
TR velocity, m/s | − 0.07 | 0.06 | − 0.02 | 0.76 |
TAPSE, mm | 0.22 | < 0.001 | 0.27 | < 0.001 |
RV S’, m/s | 0.23 | < 0.001 | 0.25 | < 0.001 |
FAC, % | 0.09 | 0.003 | 0.08 | 0.049 |
RVSP, mmHg | 0.10 | 0.007 | 0.12 | 0.001 |