Sex Differences in the Association of Cumulative Body Mass Index from Early Adulthood to Middle Age and Left Atrial Remodeling Evaluated by Three-Dimensional Echocardiography: The Coronary Artery Risk Development in Young Adults Study.


Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388

Informations de publication

Date de publication:
07 2020
Historique:
received: 08 11 2019
revised: 11 02 2020
accepted: 14 02 2020
pubmed: 28 4 2020
medline: 25 9 2021
entrez: 28 4 2020
Statut: ppublish

Résumé

The relationship between long-term obesity and left atrial (LA) structure and function is not entirely understood. We examined the association of cumulative body mass index (cBMI) with LA remodeling using three-dimensional (3D) speckle-tracking echocardiography (STE). The Coronary Artery Risk Development in Young Adults (CARDIA) study is a community-based cohort of black and white, men and women, ages 18-30 years at baseline in 1985-86 from four U.S. centers. This study included 2,144 participants who had satisfactory image quality and body mass index measurements during the entire follow-up period. The 3D STE-derived LA parameters were maximum, minimum, and pretrial contraction volumes; total, passive, and active emptying fraction; maximum systolic longitudinal strain; and early and late diastolic longitudinal strain rates. Multivariable linear regression analyses stratified by sex assessed the relationship between cBMI and 3D STE-derived LA parameters, adjusting for demographics and traditional cardiovascular. The mean age of the cohort was 55 ± 3.6 years; 54.8% were women, and 46.5% were black. There were statistically significant additive sex interactions for the association between cBMI and LA minimum contraction value, maximum systolic longitudinal strain, and early and late diastolic longitudinal strain rates. In the fully adjusted model, greater cBMI was associated with lower magnitude LA longitudinal deformation (maximum systolic longitudinal strain and early and late diastolic longitudinal strain rates) in men and with higher LA emptying fraction in women. In addition, greater cBMI was associated with higher LA phasic volumes indices in both men and women. This study showed that while greater cBMI from early adulthood throughout middle age was associated with higher LA volumes in both genders, differences were found for LA function, with lower longitudinal deformation in men and higher reservoir and active LA function in women.

Sections du résumé

BACKGROUND
The relationship between long-term obesity and left atrial (LA) structure and function is not entirely understood. We examined the association of cumulative body mass index (cBMI) with LA remodeling using three-dimensional (3D) speckle-tracking echocardiography (STE).
METHODS
The Coronary Artery Risk Development in Young Adults (CARDIA) study is a community-based cohort of black and white, men and women, ages 18-30 years at baseline in 1985-86 from four U.S. centers. This study included 2,144 participants who had satisfactory image quality and body mass index measurements during the entire follow-up period. The 3D STE-derived LA parameters were maximum, minimum, and pretrial contraction volumes; total, passive, and active emptying fraction; maximum systolic longitudinal strain; and early and late diastolic longitudinal strain rates. Multivariable linear regression analyses stratified by sex assessed the relationship between cBMI and 3D STE-derived LA parameters, adjusting for demographics and traditional cardiovascular.
RESULTS
The mean age of the cohort was 55 ± 3.6 years; 54.8% were women, and 46.5% were black. There were statistically significant additive sex interactions for the association between cBMI and LA minimum contraction value, maximum systolic longitudinal strain, and early and late diastolic longitudinal strain rates. In the fully adjusted model, greater cBMI was associated with lower magnitude LA longitudinal deformation (maximum systolic longitudinal strain and early and late diastolic longitudinal strain rates) in men and with higher LA emptying fraction in women. In addition, greater cBMI was associated with higher LA phasic volumes indices in both men and women.
CONCLUSIONS
This study showed that while greater cBMI from early adulthood throughout middle age was associated with higher LA volumes in both genders, differences were found for LA function, with lower longitudinal deformation in men and higher reservoir and active LA function in women.

Identifiants

pubmed: 32336609
pii: S0894-7317(20)30129-2
doi: 10.1016/j.echo.2020.02.013
pmc: PMC7388576
mid: NIHMS1587458
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

878-887.e3

Subventions

Organisme : NHLBI NIH HHS
ID : HHSN268201800004I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800003I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800007I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800005I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201800006I
Pays : United States

Informations de copyright

Copyright © 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

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Auteurs

Henrique Doria de Vasconcellos (H)

Johns Hopkins University, Baltimore, Maryland; Universidade Federal do Vale do Sao Francisco/School of Medicine, Petrolina, Pernambuco.

Aisha Betoko (A)

Johns Hopkins University, Baltimore, Maryland.

Luisa A Ciuffo (LA)

Johns Hopkins University, Baltimore, Maryland.

Henrique T Moreira (HT)

Johns Hopkins University, Baltimore, Maryland; University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.

Chike C Nwabuo (CC)

Johns Hopkins University, Baltimore, Maryland.

Bharath Ambale-Venkatesh (B)

Johns Hopkins University, Baltimore, Maryland.

Jared P Reis (JP)

National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Norrina Allen (N)

Northwestern University, Chicago, Illinois.

Donald M Lloyd-Jones (DM)

Northwestern University, Chicago, Illinois.

Laura A Colangelo (LA)

Northwestern University, Chicago, Illinois.

Pamela J Schreiner (PJ)

University of Minnesota, Minneapolis, Minnesota.

Cora E Lewis (CE)

University of Alabama, Birmingham, Alabama.

James M Shikany (JM)

University of Alabama, Birmingham, Alabama.

Stephen Sidney (S)

Kaiser Permanent, Oakland, California.

Christopher Cox (C)

Johns Hopkins University, Baltimore, Maryland.

Samuel S Gidding (SS)

FH Foundation, Pasadena, CA.

Joao A C Lima (JAC)

Johns Hopkins University, Baltimore, Maryland. Electronic address: jlima@jhmi.edu.

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Classifications MeSH