Left ventricular concentric remodeling is highly common among veterans deployed to Southwest Asia and is associated with impaired exercise performance

Left ventricular concentric remodeling (LVCR), a pathological process of adaptive myocardial change, may be a precursor state for systolic and diastolic dysfunction and LV hypertrophy. Potential cardiotoxic airborne hazards present in combat zones in excess may increase the risk for adverse cardiac remodeling in deployed veterans. One hundred and thirty-nine deployed veterans were included in this study and underwent evaluations including transthoracic echocardiography and cardiopulmonary exercise testing (CPET). Relative wall thickness was used to classify LV geometry as normal, concentric or eccentric hypertrophy, or LVCR. Observed rates of LVCR were compared to those reported in the Framingham Heart Study (FHS), and CPET results were compared between those with and without LVCR. Rates of LVCR in our veteran sample (12%-34%) were elevated compared to FHS (8%-21%), despite similar demographics and risk factors. Veterans with LVCR had reduced exercise capacity, greater ventilatory inefficiency, and increased heart rate reserve relative to those without. Deployment length was associated with increased odds of having LVCR (aOR = 1.04, 95% CI [1.01, 1.07]). Abnormal LV geometry, specifically LVCR, was common in our veteran sample and exceeded historical civilian rates. The presence of LVCR was associated with impaired exercise performance and was more likely in those with longer deployment lengths.