CV risk factors linked with right-ventricular remodeling
MedWire News: Cardiovascular risk factors such as raised cholesterol and blood pressure are associated with subclinical changes in right-ventricular (RV) mass and volume, researchers from the US National Institutes of Health report.
They say that these deleterious changes to the RV are similar to those seen in the left ventricle (LV) in response to cardiovascular risk factors, although the underlying pathophysiologic pathways may differ.
David Bluemke (National Heart, Lung, and Blood Institute, Bethesda, Maryland) and team analyzed cardiac magnetic resonance images from 4204 participants in the Multi-Ethnic Study of Atherosclerosis. This was a study of adults, aged 45–84 years, without clinical cardiovascular disease at enrolment.
The researchers used multivariate linear regression models to study the cross-sectional association between individual RV parameters and risk factors.
Writing in the American Journal of Cardiology, they report that four RV parameters – mass, end-diastolic volume, end-systolic volume, and stroke volume – decreased with age. In particular, RV mass was approximately 20% lower in the oldest versus the youngest participants.
RV mass was positively associated with systolic blood pressure and high-density lipoprotein (HDL) cholesterol and inversely associated with diastolic blood pressure and total cholesterol.
RV end-diastolic volume was positively associated with systolic blood pressure and HDL cholesterol and inversely associated with diastolic blood pressure, total cholesterol, current smoking, and diabetes mellitus.
Finally, RV ejection fraction was positively associated with systolic blood pressure and HDL cholesterol and inversely associated with diastolic blood pressure.
Most risk factors showed a diminished association with RV parameters after adjusting for LV parameters, leading the authors to remark: “It seems reasonable to believe that the cardiovascular risk factors associated with changes in the LV might also influence the adjoining RV to a certain degree.”
However, they say the changes in the LV and RV “might be mediated through different systemic and pulmonary vascular pathways, respectively.”
The researchers also note that the present study was limited to people without symptomatic cardiovascular disease, concluding: “The effects of cardiovascular risk factors could be different in those with existing cardiovascular disease.”
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By Joanna Lyford