Association of Patterns of Change in Adiposity With Diastolic Function and Systolic Myocardial Mechanics From Early Adulthood to Middle Age: The Coronary Artery Risk Development in Young Adults Study

Sadiya S. Khan*, Sanjiv J. Shah, Laura A. Colangelo, Anita Panjwani, Kiang Liu, Cora E. Lewis, Christina M. Shay, David C. Goff, Jared Reis, Henrique D. Vasconcellos, Joao A.C. Lima, Donald Lloyd-Jones, Norrina B. Allen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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 ΔBMI, 1.6 kg/m2), mild increase (40%; mean ΔBMI, 6.0 kg/m2), moderate increase (18%; mean ΔBMI, 10.8 kg/m2), and major increase (6%; mean ΔBMI, 15.5 kg/m2). 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.

Original languageEnglish (US)
Pages (from-to)1261-1269.e8
JournalJournal of the American Society of Echocardiography
Volume31
Issue number12
DOIs
StatePublished - Dec 2018

Funding

The Coronary Artery Risk Development in Young Adults (CARDIA) study is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham ( HHSN268201300025C and HHSN268201300025C ), Northwestern University ( HHSN268201300027C ), the University of Minnesota ( HHSN268201300028C ), the Kaiser Foundation Research Institute ( HHSN268201300029C ), and Johns Hopkins University School of Medicine ( HHSN268200900041C ). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging and an intra-agency agreement between the National Institute on Aging and the National Heart, Lung, and Blood Institute (AG0005). This report has been reviewed by CARDIA for scientific content. Dr. Khan is supported by a research grant from the National Institutes of Health ( F32HL129695 and KL2TR001424 ). Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences (grant KL2TR001424 to S.S.K.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the US Department of Health and Human Services.

Keywords

  • Echocardiography
  • Epidemiology
  • Heart failure with preserved ejection fraction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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