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

Henrique Doria de Vasconcellos; Aisha Betoko; Luisa A. Ciuffo; Henrique T. Moreira; Chike C. Nwabuo; Bharath Ambale-Venkatesh; Jared P. Reis; Norrina Allen; Donald M. Lloyd-Jones; Laura A. Colangelo; Pamela J. Schreiner; Cora E. Lewis; James M. Shikany; Stephen Sidney; Christopher Cox; Samuel S. Gidding; Joao A.C. Lima

doi:10.1016/j.echo.2020.02.013

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

Henrique Doria de Vasconcellos, Aisha Betoko, Luisa A. Ciuffo, Henrique T. Moreira, Chike C. Nwabuo, Bharath Ambale-Venkatesh, Jared P. Reis, Norrina Allen, Donald M. Lloyd-Jones, Laura A. Colangelo, Pamela J. Schreiner, Cora E. Lewis, James M. Shikany, Stephen Sidney, Christopher Cox, Samuel S. Gidding, Joao A.C. Lima^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	878-887.e3
Journal	Journal of the American Society of Echocardiography
Volume	33
Issue number	7
DOIs	https://doi.org/10.1016/j.echo.2020.02.013
State	Published - Jul 2020

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 ( HHSN268201800005I and HHSN268201800007I ), Northwestern University ( HHSN268201800003I ), University of Minnesota ( HHSN268201800006I ), and Kaiser Foundation Research Institute ( HHSN268201800004I ). This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the U.S. Department of Health and Human Services. 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 (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This manuscript has been reviewed by CARDIA for scientific content. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the U.S. Department of Health and Human Services.

Keywords

3D echocardiography
Body mass index
Gender
Left atrium remodeling

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Doria de Vasconcellos, H., Betoko, A., Ciuffo, L. A., Moreira, H. T., Nwabuo, C. C., Ambale-Venkatesh, B., Reis, J. P., Allen, N., Lloyd-Jones, D. M., Colangelo, L. A., Schreiner, P. J., Lewis, C. E., Shikany, J. M., Sidney, S., Cox, C., Gidding, S. S., & Lima, J. A. C. (2020). 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 of the American Society of Echocardiography, 33(7), 878-887.e3. https://doi.org/10.1016/j.echo.2020.02.013

Doria de Vasconcellos, Henrique ; Betoko, Aisha ; Ciuffo, Luisa A. et al. / 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. In: Journal of the American Society of Echocardiography. 2020 ; Vol. 33, No. 7. pp. 878-887.e3.

@article{8da17badc08a45eab84d7f71b3090786,

title = "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",

abstract = "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.",

keywords = "3D echocardiography, Body mass index, Gender, Left atrium remodeling",

author = "{Doria de Vasconcellos}, Henrique and Aisha Betoko and Ciuffo, {Luisa A.} and Moreira, {Henrique T.} and Nwabuo, {Chike C.} and Bharath Ambale-Venkatesh and Reis, {Jared P.} and Norrina Allen and Lloyd-Jones, {Donald M.} and Colangelo, {Laura A.} and Schreiner, {Pamela J.} and Lewis, {Cora E.} and Shikany, {James M.} and Stephen Sidney and Christopher Cox and Gidding, {Samuel S.} and Lima, {Joao A.C.}",

note = "Publisher Copyright: {\textcopyright} 2020 American Society of Echocardiography",

year = "2020",

month = jul,

doi = "10.1016/j.echo.2020.02.013",

language = "English (US)",

volume = "33",

pages = "878--887.e3",

journal = "Journal of the American Society of Echocardiography",

issn = "0894-7317",

publisher = "Elsevier Inc.",

number = "7",

}

Doria de Vasconcellos, H, Betoko, A, Ciuffo, LA, Moreira, HT, Nwabuo, CC, Ambale-Venkatesh, B, Reis, JP, Allen, N, Lloyd-Jones, DM, Colangelo, LA, Schreiner, PJ, Lewis, CE, Shikany, JM, Sidney, S, Cox, C, Gidding, SS & Lima, JAC 2020, '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 of the American Society of Echocardiography, vol. 33, no. 7, pp. 878-887.e3. https://doi.org/10.1016/j.echo.2020.02.013

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. / Doria de Vasconcellos, Henrique; Betoko, Aisha; Ciuffo, Luisa A. et al.
In: Journal of the American Society of Echocardiography, Vol. 33, No. 7, 07.2020, p. 878-887.e3.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

T2 - The Coronary Artery Risk Development in Young Adults Study

AU - Doria de Vasconcellos, Henrique

AU - Betoko, Aisha

AU - Ciuffo, Luisa A.

AU - Moreira, Henrique T.

AU - Nwabuo, Chike C.

AU - Ambale-Venkatesh, Bharath

AU - Reis, Jared P.

AU - Allen, Norrina

AU - Lloyd-Jones, Donald M.

AU - Colangelo, Laura A.

AU - Schreiner, Pamela J.

AU - Lewis, Cora E.

AU - Shikany, James M.

AU - Sidney, Stephen

AU - Cox, Christopher

AU - Gidding, Samuel S.

AU - Lima, Joao A.C.

PY - 2020/7

Y1 - 2020/7

N2 - 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.

AB - 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.

KW - 3D echocardiography

KW - Body mass index

KW - Gender

KW - Left atrium remodeling

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UR - http://www.scopus.com/inward/citedby.url?scp=85083547535&partnerID=8YFLogxK

U2 - 10.1016/j.echo.2020.02.013

DO - 10.1016/j.echo.2020.02.013

M3 - Article

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AN - SCOPUS:85083547535

SN - 0894-7317

VL - 33

SP - 878-887.e3

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

IS - 7

ER -

Doria de Vasconcellos H, Betoko A, Ciuffo LA, Moreira HT, Nwabuo CC, Ambale-Venkatesh B et al. 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 of the American Society of Echocardiography. 2020 Jul;33(7):878-887.e3. doi: 10.1016/j.echo.2020.02.013

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

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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