Abstract MP084: Associations of Left Ventricular Structure and Function in Early Adulthood With Incident Adverse Geometry and Systolic Dysfunction in Middle Age: the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Introduction: Cardiac remodeling occurs across the lifespan and predicts clinical outcomes. We hypothesized that inter-individual variability in left ventricular (LV) structure and function parameters in early adulthood would be independently associated with incident adverse LV geometry and ejection fraction (EF) <50% in middle age.
Methods: We included CARDIA participants with echocardiograms at study years (Y) 5, 25, and 30. Geometry and EF analyses included only participants free of the outcome at Y5 (i.e., normal geometry or EF≥50%, respectively). We assessed associations of indexed Y5 LV parameters, including end-systolic (ESD/ht) and -diastolic (EDD/ht) dimensions, mass (M/ht2.7), septal and posterior wall thicknesses, and EF, with incident Y30 adverse geometry (defined as LV concentric remodeling [CR], concentric hypertrophy [cLVH], or eccentric hypertrophy [eLVH]) and EF <50%. We used multivariate polytomous (for geometry) or dichotomous (for EF) logistic regression, adjusting for demographics, heart rate, and cumulative (Y5-Y25) clinical risk factor burden.
Results: Participants (N=2335) were 56% female, 44% black, and ages 23 to 35 and 48 to 60 in Y5 and Y30, respectively. With increasing age across the 3 study echocardiograms (Y5, Y25, and Y30), unadjusted mean LV M/ht2.7 and EDD/ht generally increased, while ESD/ht and EF changed minimally. Y5 LV ESD/ht and M/ht2.7 were most consistently associated with the odds for incident abnormalities in Y30 LV geometry and EF (Table). For example, Y5 LV ESD/ht and M/ht2.7 were each associated with incident eLVH by Y30 (OR 1.48 [1.25-1.74] and 1.55 [1.28-1.88] per 1 SD increment, respectively). Y5 ESD/ht was also associated with EF <50% by Y30 (OR 1.84 [1.46-2.31]).
Conclusions: In young adults with categorically normal LV geometry and systolic function, inter-individual variation in LV parameters is associated with incident concentric remodeling, hypertrophy, and EF <50% over 25 years, independent of demographics and cumulative clinical risk factor burden.
Author Disclosures: A.M. Perak: None. L.A. Colangelo: None. A.C. Armstrong: None. S.S. Gidding: None. C.E. Lewis: None. J. Lima: None. K.J. Liu:None. J.P. Reis: None. P.J. Schreiner: None. S. Sidney: None. D.M. Lloyd-Jones: None.
- © 2017 by American Heart Association, Inc.