Impact of Long-Term Burden of Excessive Adiposity and Elevated Blood Pressure From Childhood on Adulthood Left Ventricular Remodeling Patterns

BACKGROUND Cardiovascular risk factors are associated with left ventricular hypertrophy (LVH), but little is known regarding related impact of longitudinal measures of childhood adiposity and LV hemodynamic variables. OBJECTIVES The aim of this study was to examine the impact of cumulative long-term burden and trends of excessive adiposity and elevated blood pressure (BP) during childhood on adulthood LVH and LV geometric remodeling patterns. METHODS This longitudinal study consisted of 1,061 adults, age 24 to 46 years, who had been examined 4 or more times for body mass index (BMI) and BP starting in childhood, with a mean follow-up of 28.0 years. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI and BP from childhood to adulthood. Four LV geometric types were defined—normal, concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH)—all on the basis of LV mass indexed for body height (m 2.7 ) and