Abstract 454: Childhood Determinants of Subendocardial Viability Ratio in Biracial (Black-White) Young Adults: The Bogalusa Heart Study

Abstract

Background: non-invasive estimation of myocardial oxygen supply and demand as measured by Subendocardial Viability Ratio (SEVR) continues to gain importance in the early detection of coronary artery disease (CAD). While adult risk factor associations with SEVR have been documented, especially in patients with CAD, no information is available on the childhood predictors of SEVR in relatively young and healthy adults. Methods: this aspect was examined in 610 non-institutionalized individuals (68.7% whites, 54.6% females; aged 29.4 - 51.3 years) that participated in the Bogalusa Heart Study and had cardiovascular risk factors information available since childhood. SEVR was estimated in adulthood through applanation tonometry of the radial artery. The average value of childhood measurements was used as the childhood value, standardized to age, race and sex-specific z-scores. Multivariable linear regression analyses were used to estimate childhood risk factor associations with SEVR in adulthood. Results: Blacks and females had significantly lower mean levels of SEVR (p<0.001) compared to their counterparts. Body Mass Index (BMI) in childhood resulted as the only significant predictor of SEVR in white (β= -0.19, p<0.01), but not in black (β= 0.06, p=0.59) adults. No significant associations were observed in other childhood risk factors such as: high density lipoprotein cholesterol, low density lipoprotein cholesterol and blood pressure (both, systolic and diastolic) Conclusion: These findings support the hypothesis that the impact of risk factors on adult cardiovascular disease starts early in life and differs among white and black race groups. Further, the adverse effects of childhood obesity on coronary microcirculation in adulthood, as measured through SEVR, underscores the importance of primordial prevention of CV risk factors at an early age, especially obesity, to avoid regrettable complications in adulthood.