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Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults).
JACC Heart Fail. 2014 Oct; 2(5):500-8.JH

Abstract

OBJECTIVES

The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year change to left ventricular (LV) structure and function.

BACKGROUND

Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated.

METHODS

The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low: <27 kg/m(2) and high: ≥27 kg/m(2)) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors.

RESULTS

The mean BMI was 24.4 kg/m(2) in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient = 0.67; Low-High: β-coefficient = 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient = -074; Low-High: β-coefficient = -0.45 for e') and STE (High-High: β-coefficient = -0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient = 26.11; Low-High: β-coefficient = 11.87).

CONCLUSIONS

Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age 43 to 55 years.

Authors+Show Affiliations

Johns Hopkins University, Baltimore, Maryland.Johns Hopkins University, Baltimore, Maryland.Nemours Cardiac Center, Wilmington, Delaware.Northwestern University, Chicago, Illinois.Johns Hopkins University, Baltimore, Maryland.University of Minnesota School of Public Health, Minneapolis, Minnesota.Vanderbilt University School of Medicine, Nashville, Tennessee.Wake Forest University School of Medicine, Winston-Salem, North Carolina.Northwestern University, Chicago, Illinois.Colorado School of Public Health, Aurora, Colorado.Johns Hopkins University, Baltimore, Maryland. Electronic address: jlima@jhmi.edu.

Pub Type(s)

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

Language

eng

PubMed ID

25194290

Citation

Kishi, Satoru, et al. "Association of Obesity in Early Adulthood and Middle Age With Incipient Left Ventricular Dysfunction and Structural Remodeling: the CARDIA Study (Coronary Artery Risk Development in Young Adults)." JACC. Heart Failure, vol. 2, no. 5, 2014, pp. 500-8.
Kishi S, Armstrong AC, Gidding SS, et al. Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults). JACC Heart Fail. 2014;2(5):500-8.
Kishi, S., Armstrong, A. C., Gidding, S. S., Colangelo, L. A., Venkatesh, B. A., Jacobs, D. R., Carr, J. J., Terry, J. G., Liu, K., Goff, D. C., & Lima, J. A. (2014). Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults). JACC. Heart Failure, 2(5), 500-8. https://doi.org/10.1016/j.jchf.2014.03.001
Kishi S, et al. Association of Obesity in Early Adulthood and Middle Age With Incipient Left Ventricular Dysfunction and Structural Remodeling: the CARDIA Study (Coronary Artery Risk Development in Young Adults). JACC Heart Fail. 2014;2(5):500-8. PubMed PMID: 25194290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults). AU - Kishi,Satoru, AU - Armstrong,Anderson C, AU - Gidding,Samuel S, AU - Colangelo,Laura A, AU - Venkatesh,Bharath A, AU - Jacobs,David R,Jr AU - Carr,J Jeffery, AU - Terry,James G, AU - Liu,Kiang, AU - Goff,David C,Jr AU - Lima,João A C, Y1 - 2014/09/03/ PY - 2013/12/13/received PY - 2014/03/05/revised PY - 2014/03/17/accepted PY - 2014/9/8/entrez PY - 2014/9/10/pubmed PY - 2015/11/3/medline KW - echocardiography KW - left ventricular function KW - left ventricular remodeling KW - obesity KW - risk factors KW - speckle tracking echocardiography KW - tissue Doppler imaging SP - 500 EP - 8 JF - JACC. Heart failure JO - JACC Heart Fail VL - 2 IS - 5 N2 - OBJECTIVES: The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year change to left ventricular (LV) structure and function. BACKGROUND: Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. METHODS: The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low: <27 kg/m(2) and high: ≥27 kg/m(2)) was categorized into 4 groups (Low-Low, High-Low, Low-High, and High-High). Multiple linear regression was used to quantify the association between categorical changes in BMI (Low-Low as reference) with LV structural and functional parameters obtained in middle age, adjusting for baseline and 25-year change in risk factors. RESULTS: The mean BMI was 24.4 kg/m(2) in 3,265 participants included at Year-0. Change in BMI adjusted for risk factors was directly associated with incipient myocardial systolic dysfunction assessed by STE (High-High: β-coefficient = 0.67; Low-High: β-coefficient = 0.35 for longitudinal peak systolic strain) and diastolic dysfunction assessed by TDI (High-High: β-coefficient = -074; Low-High: β-coefficient = -0.45 for e') and STE (High-High: β-coefficient = -0.06 for circumferential early diastolic strain rate). Greater BMI was also significantly associated with increased LV mass/height (High-High: β-coefficient = 26.11; Low-High: β-coefficient = 11.87). CONCLUSIONS: Longstanding obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age 43 to 55 years. SN - 2213-1787 UR - https://www.unboundmedicine.com/medline/citation/25194290/Association_of_obesity_in_early_adulthood_and_middle_age_with_incipient_left_ventricular_dysfunction_and_structural_remodeling:_the_CARDIA_study__Coronary_Artery_Risk_Development_in_Young_Adults__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1779(14)00073-0 DB - PRIME DP - Unbound Medicine ER -