Abstract
BackgroundThe association of longitudinal trajectories of cardiovascular risk factors with cardiovascular magnetic resonance (CMR)-measures of cardiac structure and function in the community is not well known. Therefore we aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort.MethodsWe assessed conventional cardiovascular disease risk factors in 349 participants (143 women; aged 25–59 years) at three examination cycles (Exam 1 [baseline], at Exam 2 [7-years follow-up] and at Exam 3 [14-years follow-up]) of the KORA S4 cohort and related single-point measurements of individual risk factors and longitudinal trajectories of these risk factors to various CMR-measures obtained at Exam 3.ResultsHigh levels of diastolic blood pressure, waist circumference, and LDL-cholesterol at the individual exams were associated with worse cardiac function and structure. Trajectory clusters representing higher levels of the individual risk factors were associated with worse cardiac function and structure compared to low risk trajectory clusters of individual risk factors. Multivariable (combining different risk factors) trajectory clusters were associated with different cardiac parameters in a graded fashion (e.g. decrease of LV stroke volume for middle risk cluster β = − 4.91 ml/m2, 95% CI − 7.89; − 1.94, p < 0.01 and high risk cluster β = − 7.00 ml/m2, 95% CI − 10.73; − 3.28, p < 0.001 compared to the low risk cluster). The multivariable longitudinal trajectory clusters added significantly to explain variation in CMR traits beyond the multivariable risk profile obtained at Exam 3.ConclusionsCardiovascular disease risk factor levels, measured over a time period of 14 years, were associated with CMR-derived measures of cardiac structure and function. Longitudinal multivariable trajectory clusters explained a greater proportion of the inter-individual variation in cardiac traits than multiple risk factor assessed contemporaneous with the CMR exam.
Highlights
The association of standard cardiovascular disease (CVD) risk factors with prevalent and incident CVD events [1,2,3] and with subclinical CVD traits, including parameters of left ventricular (LV) remodeling, is well established [4, 5]
We investigated cardiovascular magnetic resonance (CMR) parameters that were most strongly correlated with CVD risk factors in previous studies of this sample (LV: end-diastolic volume, stroke volume, diastolic myocardial mass, early diastolic filling rate; right ventricle (RV): end-diastolic volume, stroke volume; fat: epicardial, diastolic) [14, 16,17,18]
Over the 14-year period from Exam 1 to Exam 3, we observed an increase in hypertension prevalence (29– 33%), and in mean levels of Hemoglobin A1c (HbA1c) (5.48–5.56%), waist circumference (90.6–98.4 cm) and LDL-cholesterol
Summary
The association of standard cardiovascular disease (CVD) risk factors with prevalent and incident CVD events [1,2,3] and with subclinical CVD traits, including parameters of left ventricular (LV) remodeling, is well established [4, 5]. Data on longitudinal trajectories of risk factors and on the associations of these trajectories with subclinical and clinical CVD are limited [6] In this context, it is not well known, whether information about cumulative risk factor burden over an extended period of time is more strongly related to clinical and subclinical CVD traits than measurements of CVD risk factors at one point in time Few prior studies have related cardiac CMR-derived measures to established CVD risk factors, including systolic blood pressure (BP), body mass index (BMI) and total cholesterol, obtained at one point in time [9, 10]. These studies reported statistically significant associations, e. We aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort
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