Roberto Lorbeer1,2, Susanne Rospleszcz3,4,5, Christopher L Schlett6, Sophia D Rado7, Barbara Thorand4,8, Christa Meisinger4,9, Wolfgang Rathmann10,11, Margit Heier4,12, Ramachandran S Vasan13, Fabian Bamberg6, Annette Peters3,4,5,8, Wolfgang Lieb14. 1. Department of Radiology, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany. roberto.lorbeer@med.uni-muenchen.de. 2. German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany. roberto.lorbeer@med.uni-muenchen.de. 3. German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany. 4. Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany. 5. Chair of Epidemiology, Institute of Medical Information Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany. 6. Department of Diagnostic and Interventional Radiology, Medical Center, University Freiburg, Freiburg, Germany. 7. Department of Diagnostic and Interventional Radiology, Eberhard Karl University Tübingen, Tübingen, Germany. 8. German Center for Diabetes Research (DZD E.V.), Neuherberg, Germany. 9. Chair of Epidemiology, LMU Munich, UNIKA-T Augsburg, Augsburg, Germany. 10. Institute for Biometrics and Epidemiology, German Diabetes Center, Düsseldorf, Germany. 11. Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany. 12. KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany. 13. Preventive Medicine and Epidemiology Section, Boston University School of Medicine and Framingham Heart Study, Framingham, MA, USA. 14. Institute of Epidemiology, Kiel University, Kiel, Germany.
Abstract
BACKGROUND: The 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. METHODS: We 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. RESULTS: High 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. CONCLUSIONS: Cardiovascular 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.
BACKGROUND: The 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. METHODS: We 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. RESULTS: High 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. CONCLUSIONS:Cardiovascular 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.
Entities:
Keywords:
Cardiac MRI; Cardiac function and structure; Cohort study; Risk factors
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