Journal
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
Volume 31, Issue 12, Pages 1261-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.echo.2018.07.014
Keywords
Echocardiography; Heart failure with preserved ejection fraction; Epidemiology
Categories
Funding
- National Heart, Lung, and Blood Institute
- University of Alabama at Birmingham [HHSN268201300025C]
- Northwestern University [HHSN268201300027C]
- University of Minnesota [HHSN268201300028C]
- Kaiser Foundation Research Institute [HHSN268201300029C]
- Johns Hopkins University School of Medicine [HHSN268200900041C]
- Intramural Research Program of the National Institute on Aging
- National Institute on Aging [AG0005]
- National Heart, Lung, and Blood Institute [AG0005]
- National Institutes of Health [F32HL129695, KL2TR001424]
- National Institutes of Health's National Center for Advancing Translational Sciences [KL2TR001424]
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [KL2TR001424] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [F32HL129695] Funding Source: NIH RePORTER
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Background: The aim of this study was to determine whether long-term patterns of change in adiposity throughout young adulthood are associated with systolic and diastolic function in midlife. Methods: Participants in the Coronary Artery Risk Development in Young Adults study, a multicenter, population-based cohort, underwent repeated anthropometric assessment (body mass index [BMI], waist circumference, and waist-to-hip ratio) from examination years 0 to 25. At year 25, longitudinal, circumferential, and radial strain and tissue Doppler velocities were assessed by echocardiography. Group-based trajectory modeling was used to identify 25-year trajectories of change in anthropometric measures and to examine associations between trajectories of adiposity change and indices of cardiac mechanics. Results: Among 3,310 participants, four distinct trajectories of BMI change were identified: stable BMI (36% of the cohort; mean Delta BMI, 1.6 kg/m(2)), mild increase (40%; mean Delta BMI, 6.0 kg/m(2)), moderate increase (18%; mean Delta BMI, 10.8 kg/m(2)), and major increase (6%; mean Delta BMI, 15.5 kg/m(2)). Trajectories of greater BMI increase were associated with lower adjusted e' velocity and higher E/e' ratio compared with the stable BMI group, independent of year 0 or year 25 BMI. Participants in increasing BMI trajectory groups compared with the stable BMI group had lower absolute longitudinal strain and greater odds of diastolic dysfunction, independent of year 0 BMI but not year 25 BMI. Similar patterns were observed for change in waist circumference and waist-to-hip ratio trajectory groups. Conclusions: Steeper trajectories of BMI increase from young adulthood to middle age, a vulnerable period for weight gain, are independently associated with lower e' velocity and higher E/e' ratio, but not systolic dysfunction, in midlife.
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