How dietary patterns affect left ventricular structure, function and remodelling: evidence from the Kardiovize Brno 2030 study

Abstract

Little is still known about the effect of dietary patterns on left ventricular hypertrophy (LVH). Here, we derived dietary patterns by principal component analysis (PCA) and evaluated their association with LV structure, function, and remodelling. Our cross-sectional study included 438 members (aged 25-65 years; 59.1% women) of the Kardiovize Brno 2030 with no history of cardiovascular disease. Two dietary patterns were derived using PCA, namely prudent and western. Primary outcomes were echocardiographic parameters and LV geometric patterns, such as concentric LV remodelling (cLVR), concentric LVH (cLVH), and eccentric LVH (eLVH). Interestingly, participants with high adherence to the prudent dietary pattern had decreased odds of cLVH after adjustment for socio-demographic, clinical and behavioral covariates (OR = 0.24, 95% CI = 0.08-0.88; p = 0.031). By contrast, several echocardiographic parameters increased with increasing adherence to the western dietary pattern, which resulted in higher odds of cLVH among participants with high adherence (OR = 5.38, 95% CI = 1.17-23.58; p = 0.035). Although our findings may have an immediate relevance for public-health strategies, further large-size prospective studies should be encouraged to better understand the observed association and their causality.

Figure 1

Correlation matrix between food intakes and echocardiographic parameters. Results are reported as Spearman’s correlation coefficient and those with p-value < 0.05 are indicated in bold. Abbreviations: interventricular septum thickness at end-diastole, IVSd; end-diastolic volume, EDV; posterior wall thickness at end-diastole, LVPWd; left ventricle mass, LVM; left ventricle mass indexed to height^2.7, LVMI; left ventricle end-systolic diameter, LVIDs; ejection fraction, EF; left atrial diameter, LA Diameter; right ventricle diameter, RVID; aortic diameter at the sinus of Valsalva, Aosinus; relative wall thickness, RWT.

Figure 2

Radar graph of factor loadings characterizing dietary patterns. Red line indicates factor loadings related to the western dietary pattern. Green line indicates factor loadings related to the prudent dietary pattern. Dietary patterns are described based on factor loadings with absolute value ≥0.25.

Figure 3

Association of dietary patterns with echocardiographic parameters and left ventricular remodelling. (A) Correlation matrix between factor scores and echocardiographic parameters; results are reported as Spearman’s correlation coefficient and those with p-value < 0.05 are indicated in bold. (B) Distribution of left ventricular remodelling patterns by adherence to the prudent dietary pattern. (C) Distribution of left ventricular remodelling patterns by adherence to the western dietary pattern. Abbreviations: interventricular septum thickness at end-diastole, IVSd; end-diastolic volume, EDV; posterior wall thickness at end-diastole, LVPWd; left ventricle mass, LVM; left ventricle mass indexed to height^2.7, LVMI; left ventricle end-systolic diameter, LVIDs; ejection fraction, EF; left atrial diameter, LA Diameter; right ventricle diameter, RVID; aortic diameter at the sinus of Valsalva, Aosinus; relative wall thickness, RWT.