Association of obesity in early adulthoodand middle age with incipientleft ventricular dysfunction andstructural remodeling

The cardia study (Coronary Artery Risk Development inYoung Adults).

Satoru Kishi, Anderson C. Armstrong, Samuel S. Gidding, Laura A. Colangelo, Bharath Ambale Venkatesh, David R. Jacobs, J. Jeffery Carr, James G. Terry, Kiang Liu, David C. Goff, Joao Lima

Research output: Contribution to journalArticle

Abstract

Objectives: The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year changeto left ventricular (LV) structure and function. Background: Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. Methods: The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low:2 and high:≥27 kg/m2) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. Results: The mean BMI was 24.4 kg/m2 in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient= 0.67; Low-High: β-coefficient= 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient=-074; Low-High: β-coefficient=-0.45 for e') and STE (High-High: β-coefficient=-0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient= 26.11; Low-High: β-coefficient= 11.87). Conclusions: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic anddiastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age43to 55years.

Original languageEnglish (US)
Pages (from-to)500-508
Number of pages9
JournalJACC: Heart Failure
Volume2
Issue number5
DOIs
StatePublished - Oct 1 2014

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Ventricular Dysfunction
Cardia
Coronary Vessels
Body Mass Index
Obesity
Echocardiography
Doppler Echocardiography
Heart Failure
Left Ventricular Function
Young Adult
Linear Models

Keywords

  • Echocardiography
  • Left ventricular function
  • Left ventricular remodeling
  • Obesity
  • Risk factors
  • Speckle tracking echocardiography
  • Tissue doppler imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of obesity in early adulthoodand middle age with incipientleft ventricular dysfunction andstructural remodeling : The cardia study (Coronary Artery Risk Development inYoung Adults). / Kishi, Satoru; Armstrong, Anderson C.; Gidding, Samuel S.; Colangelo, Laura A.; Ambale Venkatesh, Bharath; Jacobs, David R.; Carr, J. Jeffery; Terry, James G.; Liu, Kiang; Goff, David C.; Lima, Joao.

In: JACC: Heart Failure, Vol. 2, No. 5, 01.10.2014, p. 500-508.

Research output: Contribution to journalArticle

Kishi, Satoru ; Armstrong, Anderson C. ; Gidding, Samuel S. ; Colangelo, Laura A. ; Ambale Venkatesh, Bharath ; Jacobs, David R. ; Carr, J. Jeffery ; Terry, James G. ; Liu, Kiang ; Goff, David C. ; Lima, Joao. / Association of obesity in early adulthoodand middle age with incipientleft ventricular dysfunction andstructural remodeling : The cardia study (Coronary Artery Risk Development inYoung Adults). In: JACC: Heart Failure. 2014 ; Vol. 2, No. 5. pp. 500-508.
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abstract = "Objectives: The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year changeto left ventricular (LV) structure and function. Background: Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. Methods: The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low:2 and high:≥27 kg/m2) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. Results: The mean BMI was 24.4 kg/m2 in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient= 0.67; Low-High: β-coefficient= 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient=-074; Low-High: β-coefficient=-0.45 for e') and STE (High-High: β-coefficient=-0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient= 26.11; Low-High: β-coefficient= 11.87). Conclusions: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic anddiastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age43to 55years.",
keywords = "Echocardiography, Left ventricular function, Left ventricular remodeling, Obesity, Risk factors, Speckle tracking echocardiography, Tissue doppler imaging",
author = "Satoru Kishi and Armstrong, {Anderson C.} and Gidding, {Samuel S.} and Colangelo, {Laura A.} and {Ambale Venkatesh}, Bharath and Jacobs, {David R.} and Carr, {J. Jeffery} and Terry, {James G.} and Kiang Liu and Goff, {David C.} and Joao Lima",
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T1 - Association of obesity in early adulthoodand middle age with incipientleft ventricular dysfunction andstructural remodeling

T2 - The cardia study (Coronary Artery Risk Development inYoung Adults).

AU - Kishi, Satoru

AU - Armstrong, Anderson C.

AU - Gidding, Samuel S.

AU - Colangelo, Laura A.

AU - Ambale Venkatesh, Bharath

AU - Jacobs, David R.

AU - Carr, J. Jeffery

AU - Terry, James G.

AU - Liu, Kiang

AU - Goff, David C.

AU - Lima, Joao

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Objectives: The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year changeto left ventricular (LV) structure and function. Background: Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. Methods: The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low:2 and high:≥27 kg/m2) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. Results: The mean BMI was 24.4 kg/m2 in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient= 0.67; Low-High: β-coefficient= 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient=-074; Low-High: β-coefficient=-0.45 for e') and STE (High-High: β-coefficient=-0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient= 26.11; Low-High: β-coefficient= 11.87). Conclusions: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic anddiastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age43to 55years.

AB - Objectives: The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year changeto left ventricular (LV) structure and function. Background: Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. Methods: The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low:2 and high:≥27 kg/m2) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. Results: The mean BMI was 24.4 kg/m2 in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient= 0.67; Low-High: β-coefficient= 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient=-074; Low-High: β-coefficient=-0.45 for e') and STE (High-High: β-coefficient=-0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient= 26.11; Low-High: β-coefficient= 11.87). Conclusions: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic anddiastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age43to 55years.

KW - Echocardiography

KW - Left ventricular function

KW - Left ventricular remodeling

KW - Obesity

KW - Risk factors

KW - Speckle tracking echocardiography

KW - Tissue doppler imaging

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