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7. Abstract 16939: Association of Change in BMI From Early Adulthood to Middle Age With Left Atrial Structure and Function by Three-dimension Speckle Tracking Echocardiography: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Author

Doria de Vasconcellos, Henrique, Betoko, Aisha S, Ciuffo, Luisa, Ambale-Venkatesh, Bharat, Moreira, Henrique T, Reis, Jared P, Allen, Norrina, Lloyd-Jones, Donald, Colangelo, Laura, Schreiner, Pamela, Lewis, Cora E, Sidney, Stephen, Cox, Christopher, Gidding, Samuel S, and Lima, Joao A

Published
2017

12. Pentoxifylline Reduces Inflammation And Myocardial Perfusion Derangements In Experimental Chronic Chagas Cardiomyopathy In Hamsters.

Author

Tanaka, Denise Mayumi, primary, Fabricio, Camila G., additional, Marin-Neto, José A., additional, Barros-Filho, Antônio C.L., additional, Lopes, Carla D., additional, Oliveira, Luciano F.L., additional, Resende, Alessandra A., additional, Moreira, Henrique T., additional, Mejia, Jorge, additional, Higuchi, Maria L., additional, Cunha-Neto, Edecio, additional, Romano, Minna M.D., additional, Schmidt, André, additional, and Simoes, Marcus, additional

Published
2022
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13. Prospective Analysis of Myocardial Strain Through The Evolution of Chagas Disease In The Hamster Animal Model

Author

Ribeiro, Fernando F.F., primary, Moreira, Henrique T., additional, Filho, Antônio L.C. Barros, additional, Tanaka, Denise M., additional, Fabricio, Camila G., additional, Oliveira, Luciano F.L., additional, Prado, Cibele M., additional, Simoes, Marcus V., additional, Schmidt, Andre, additional, Maciel, Benedito C., additional, Marin-Neto, Jose A., additional, and R, Minna M.D., additional

Published
2021
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14. Feasibility and reference intervals assessed by conventional and speckle‐tracking echocardiography in normal hamsters

Author

Barros Filho, Antonio C. L., primary, Moreira, Henrique T., additional, Dias, Beatriz P., additional, Ribeiro, Fernando F. F., additional, Tanaka, Denise M., additional, Schmidt, André, additional, Maciel, Benedito C., additional, Simões, Marcus V., additional, Marin‐Neto, José A., additional, and Romano, Minna M. D., additional

Published
2021
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15. Prospective Analysis of Myocardial Strain Through Evolution of Chagas Disease in the Hamster Animal Model

Author

Ribeiro, Fernando F.F., primary, Moreira, Henrique T., additional, Barros-Filho, Antônio C.L., additional, Tanaka, Denise M, additional, Fabricio, Camila G., additional, Oliveira, Luciano F.L., additional, Prado, Cibele M, additional, Simões, Marcus V., additional, Schmidt, André, additional, Maciel, Benedito Carlos, additional, Marin-Neto, José Antônio, additional, and Romano, Minna Moreira Dias, additional

Published
2021
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17. Sex Differences in the Association of Cumulative Body Mass Index from Early Adulthood to Middle Age and Left Atrial Remodeling Evaluated by Three-Dimensional Echocardiography: The Coronary Artery Risk Development in Young Adults Study

Author

Doria de Vasconcellos, Henrique, primary, Betoko, Aisha, additional, Ciuffo, Luisa A., additional, Moreira, Henrique T., additional, Nwabuo, Chike C., additional, Ambale-Venkatesh, Bharath, additional, Reis, Jared P., additional, Allen, Norrina, additional, Lloyd-Jones, Donald M., additional, Colangelo, Laura A., additional, Schreiner, Pamela J., additional, Lewis, Cora E., additional, Shikany, James M., additional, Sidney, Stephen, additional, Cox, Christopher, additional, Gidding, Samuel S., additional, and Lima, Joao A.C., additional

Published
2020
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19. Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life

Author

Nwabuo, Chike C., primary, Yano, Yuichiro, additional, Moreira, Henrique T., additional, Appiah, Duke, additional, Vasconcellos, Henrique D., additional, Aghaji, Queen N., additional, Viera, Anthony, additional, Rana, Jamal S., additional, Shah, Ravi V., additional, Murthy, Venkatesh L., additional, Allen, Norrina B., additional, Schreiner, Pamela J., additional, Lloyd-Jones, Donald M., additional, and Lima, João A. C., additional

Published
2020
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20. Coffee and tea consumption in the early adult lifespan and left ventricular function in middle age: the CARDIA study

Author

Nwabuo, Chike C., primary, Betoko, Aisha S., additional, Reis, Jared P., additional, Moreira, Henrique T., additional, Vasconcellos, Henrique D., additional, Guallar, Eliseo, additional, Cox, Christopher, additional, Sidney, Stephen, additional, Ambale‐Venkatesh, Bharath, additional, Lewis, Cora E., additional, Schreiner, Pamela J., additional, Lloyd‐Jones, Donald, additional, Kiefe, Catarina I., additional, Gidding, Samuel S., additional, and Lima, João A.C., additional

Published
2020
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21. Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study

Author

Nwabuo, Chike C, primary, Appiah, Duke, additional, Moreira, Henrique T, additional, Vasconcellos, Henrique D, additional, Yano, Yuichiro, additional, Reis, Jared P, additional, Shah, Ravi V, additional, Murthy, Venkatesh L, additional, Allen, Norrina B, additional, Sidney, Stephen, additional, Muntner, Paul, additional, Lewis, Cora E, additional, Lloyd-Jones, Donald M, additional, Schreiner, Pamela J, additional, Gidding, Samuel S, additional, and Lima, João A C, additional

Published
2020
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22. Association of smoking and right ventricular function in middle age: CARDIA study

Author

Moreira, Henrique T, primary, Armstrong, Anderson C, additional, Nwabuo, Chike C, additional, Vasconcellos, Henrique D, additional, Schmidt, Andre, additional, Sharma, Ravi K, additional, Ambale-Venkatesh, Bharath, additional, Ostovaneh, Mohammad R, additional, Kiefe, Catarina I, additional, Lewis, Cora E, additional, Schreiner, Pamela J, additional, Sidney, Stephen, additional, Ogunyankin, Kofo O, additional, Gidding, Samuel S, additional, and Lima, Joao A C, additional

Published
2020
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23. Pulmonary Artery Acceleration Time in Young Adulthood and Cardiovascular Outcomes Later in Life: The Coronary Artery Risk Development in Young Adults Study

Author

Moreira, Henrique T., primary, Vasconcellos, Henrique D., additional, Ambale-Venkatesh, Bharath, additional, Brittain, Evan L., additional, Nwabuo, Chike C., additional, Schmidt, André, additional, Lloyd-Jones, Donald M., additional, Carr, John J., additional, Lewis, Cora E., additional, Jacobs, David R., additional, Gidding, Samuel S., additional, and Lima, João A.C., additional

Published
2020
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24. Long-termcumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study.

Author

Nwabuo, Chike C., Appiah, Duke, Moreira, Henrique T., Vasconcellos, Henrique D., Yuichiro Yano, Reis, Jared P., Shah, Ravi V., Murthy, Venkatesh L., Allen, Norrina B., Sidney, Stephen, Muntner, Paul, Lewis, Cora E., Lloyd-Jones, Donald M., Schreiner, Pamela J., Gidding, Samuel S., and Lima, João A. C.

Published
2021
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25. Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study

Author

Nwabuo, Chike C, Appiah, Duke, Moreira, Henrique T, Vasconcellos, Henrique D, Yano, Yuichiro, Reis, Jared P, Shah, Ravi V, Murthy, Venkatesh L, Allen, Norrina B, Sidney, Stephen, Muntner, Paul, Lewis, Cora E, Lloyd-Jones, Donald M, Schreiner, Pamela J, Gidding, Samuel S, and Lima, João A C

Published
2021
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26. Imaging Diagnosis of Right Ventricle Involvement in Chagas Cardiomyopathy

Author

Romano, Minna M. D., Moreira, Henrique T., Schmidt, André, Maciel, Benedito Carlos, and Marin-Neto, José Antônio

Subjects
Article Subject
Abstract

Right ventricle (RV) is considered a neglected chamber in cardiology and knowledge about its role in cardiac function was mostly focused on ventricular interdependence. However, progress on the understanding of myocardium diseases primarily involving the RV led to a better comprehension of its role in health and disease. In Chagas disease (CD), there is direct evidence from both basic and clinical research of profound structural RV abnormalities. However, clinical detection of these abnormalities is hindered by technical limitations of imaging diagnostic tools. Echocardiography has been a widespread and low-cost option for the study of patients with CD but, when applied to the RV assessment, faces difficulties such as the absence of a geometrical shape to represent this cavity. More recently, the technique has evolved to a focused guided RV imaging and myocardial deformation analysis. Also, cardiac magnetic resonance (CMR) has been introduced as a gold standard method to evaluate RV cavity volumes. CMR advantages include precise quantitative analyses of both LV and RV volumes and its ability to perform myocardium tissue characterization to identify areas of scar and edema. Evolution of these cardiac diagnostic techniques opened a new path to explore the pathophysiology of RV dysfunction in CD.

Published
2017
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27. Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study

Author

Nwabuo, Chike C, primary, Moreira, Henrique T, additional, Vasconcellos, Henrique D, additional, Mewton, Nathan, additional, Opdahl, Anders, additional, Ogunyankin, Kofo O, additional, Ambale-Venkatesh, Bharath, additional, Schreiner, Pamela J, additional, Armstrong, Anderson A C, additional, Lewis, Cora E, additional, Jacobs, David R, additional, Lloyd-Jones, Donald, additional, Gidding, Samuel S, additional, and Lima, João A C, additional

Published
2018
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28. Cumulative blood pressure from early adulthood to middle age is associated with left atrial remodelling and subclinical dysfunction assessed by three-dimensional echocardiography: a prospective post hoc analysis from the coronary artery risk development in young adults study

Author

Vasconcellos, Henrique D, primary, Moreira, Henrique T, additional, Ciuffo, Luisa, additional, Nwabuo, Chike C, additional, Yared, Guilherme S, additional, Ambale-Venkatesh, Bharath, additional, Armstrong, Anderson C, additional, Kishi, Satoru, additional, Reis, Jared P, additional, Liu, Kiang, additional, Lloyd-Jones, Donald M, additional, Colangelo, Laura A, additional, Schreiner, Pamela J, additional, Sidney, Stephen, additional, Gidding, Samuel S, additional, and Lima, Joao A C, additional

Published
2018
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29. Metabolic Syndrome Is Associated With Impaired Diastolic Function Independently of MRI-Derived Myocardial Extracellular Volume: The MESA Study

Author

Ladeiras-Lopes, Ricardo, primary, Moreira, Henrique T., additional, Bettencourt, Nuno, additional, Fontes-Carvalho, Ricardo, additional, Sampaio, Francisco, additional, Ambale-Venkatesh, Bharath, additional, Wu, Colin, additional, Liu, Kiang, additional, Bertoni, Alain G., additional, Ouyang, Pamela, additional, Bluemke, David A., additional, and Lima, João A., additional

Published
2018
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30. Reference Ranges and Regional Patterns of Left Ventricular Strain and Strain Rate Using Two-Dimensional Speckle-Tracking Echocardiography in a Healthy Middle-Aged Black and White Population: The CARDIA Study

Author

Moreira, Henrique T., primary, Nwabuo, Chike C., additional, Armstrong, Anderson C., additional, Kishi, Satoru, additional, Gjesdal, Ola, additional, Reis, Jared P., additional, Schreiner, Pamela J., additional, Liu, Kiang, additional, Lewis, Cora E., additional, Sidney, Stephen, additional, Gidding, Samuel S., additional, Lima, João A.C., additional, and Ambale-Venkatesh, Bharath, additional

Published
2017
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31. Right Ventricular Systolic Dysfunction in Chagas Disease Defined by Speckle-Tracking Echocardiography: A Comparative Study with Cardiac Magnetic Resonance Imaging

Author

Moreira, Henrique T., primary, Volpe, Gustavo J., additional, Marin-Neto, José A., additional, Nwabuo, Chike C., additional, Ambale-Venkatesh, Bharath, additional, Gali, Luis G., additional, Almeida-Filho, Oswaldo C., additional, Romano, Minna M.D., additional, Pazin-Filho, Antonio, additional, Maciel, Benedito C., additional, Lima, João A.C., additional, and Schmidt, André, additional

Published
2017
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32. Echocardiographic Pulmonary Artery Systolic Pressure in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: Associations With Race and Metabolic Dysregulation

Author

Brittain, Evan L., primary, Nwabuo, Chike, additional, Xu, Meng, additional, Gupta, Deepak K., additional, Hemnes, Anna R., additional, Moreira, Henrique T., additional, De Vasconcellos, Henrique Doria, additional, Terry, James G., additional, Carr, Jeffrey J., additional, and Lima, Joao A. C., additional

Published
2017
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33. Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study.

Author

Nwabuo, Chike C, Moreira, Henrique T, Vasconcellos, Henrique D, Mewton, Nathan, Opdahl, Anders, Ogunyankin, Kofo O, Ambale-Venkatesh, Bharath, Schreiner, Pamela J, Armstrong, Anderson A C, Lewis, Cora E, Jacobs, David R, Lloyd-Jones, Donald, Gidding, Samuel S, and Lima, João A C

Subjects
CARDIOVASCULAR disease diagnosis, HEART failure, BLOOD pressure, CONFIDENCE intervals, LEFT heart ventricle, SEX distribution, SMOKING, BODY mass index, VENTRICULAR ejection fraction, ADULTS, DIAGNOSIS
Abstract

Aims Left ventricular (LV) ejection fraction (LVEF) is an extensively utilized marker of LV function that is often interpreted without recourse to alterations in LV geometry and hypertrophy. LV global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance. We evaluated the prognostic utility of LVGFI from young adulthood into middle age for incident heart failure (HF) and cardiovascular disease (CVD) in comparison to LVEF. Methods and results Included were 4107 CARDIA participants with echocardiograms in Year-5 (1990–1991). LVGFI was defined as LV stroke volume/LV global volume*100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). Adjusted Cox proportional hazard models were utilized to predict incident HF and CVD outcomes. Mean age of participants was 29.8 ± 3.7 years, 55% female, and 48.7% black. Higher body mass index [beta coefficient (B) = −0.11 standard error (SE) = 0.02, P  <   0.001], higher blood pressure (B = −0.04, SE = 0.01, P  <   0.01), smoking (B = −0.82, SE = 0.22, P  < 0.001), male sex (P  < 0.001), and black race (P  < 0.001) were associated with worse LVGFI. A total of 207 incident CVD events were observed over the course of 98 035 person-years at risk. Higher LVGFI was associated with HF, hazard ratio (HR) = 0.70, 95% confidence interval (CI) (0.54–0.91), hard CVD HR = 0.83, 95% CI (0.71–0.96), and all CVD HR = 0.83, 95% CI (0.72–0.96). For HF outcomes, Harrell's C -statistic for LVGFI (0.80) was greater than LVEF (0.66). Conclusion LVGFI is a strong, independent predictor of incident HF and CVD that provides incremental prognostic value compared with LVEF. Male sex, black race, obesity, hypertension, and smoking are associated with worse LVGFI in the early adult lifespan. [ABSTRACT FROM AUTHOR]

Published
2019
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34. Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study

Author

Nwabuo, Chike C, Appiah, Duke, Moreira, Henrique T, Vasconcellos, Henrique D, Yano, Yuichiro, Reis, Jared P, Shah, Ravi V, Murthy, Venkatesh L, Allen, Norrina B, Sidney, Stephen, Muntner, Paul, Lewis, Cora E, Lloyd-Jones, Donald M, Schreiner, Pamela J, Gidding, Samuel S, and Lima, João AC

Abstract

Aims Cumulative blood pressure (BP) is a measure that incorporates the severity and duration of BP exposure. The prognostic significance of cumulative BP in young adults for cardiovascular diseases (CVDs) in comparison to BP severity alone is, however, unclear.Methods and results We investigated 3667 Coronary Artery Risk Development in Young Adults participants who attended six visits over 15 years (year-0 (1985–1986), year-2, year-5, year-7, year-l0, and year-15 exams). Cumulative BP was calculated as the area under the curve (mmHg × years) from year 0 through year 15. Cox models assessed the association between cumulative BP (year 0 through year 15), current BP (year 15), and BP change (year 0 and year 15) and CVD outcomes. Mean (standard deviation) age at year 15 was 40.2 (3.6) years, 44.1% were men, and 44.1% were African-American. Over a median follow-up of 16 years, there were 47 heart failure (HF), 103 coronary heart disease (CHD), 71 stroke, and 191 CVD events. Cumulative systolic BP (SBP) was associated with HF (hazard ratio (HR) = 2.14 (1.58–2.90)), CHD (HR = 1.49 (1.19–1.87)), stroke (HR = 1.81 (1.38–2.37)), and CVD (HR = 1.73 (1.47–2.05)). For CVD, the C-statistic for SBP (year 15) was 0.69 (0.65–0.73) and change in C-statistic with the inclusion of SBP change and cumulative SBP was 0.60 (0.56–0.65) and 0.72 (0.69–0.76), respectively. For CVD, using year-15 SBP as a reference, the net reclassification index (NRI) for cumulative SBP was 0.40 (p< 0.0001) and the NRI for SBP change was 0.22 (p= 0.001).Conclusions Cumulative BP in young adults was associated with the subsequent risk of HF, CHD, stroke, and CVD. Cumulative BP provided incremental prognostic value and improved risk reclassification for CVD, when compared to single BP assessments or changes in BP.

Published
2024
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35. THE UTILITY OF NOVEL THREE-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY PARAMETERS FOR GLOBAL LEFT VENTRICULAR DYSFUNCTION ASSESSMENT: THE CORONARY ARTERY RISK DEVELOPMENT IN YOUNG ADULTS (CARDIA) STUDY

Author

Nwabuo, Chike C., primary, Moreira, Henrique T., additional, Vasconcellos, Henrique D., additional, Yared, Guilherme, additional, Venkatesh, Bharath Ambale, additional, Kishi, Satoru, additional, Lewis, Cora, additional, Armstrong, Anderson, additional, Sidney, Stephen, additional, Lloyd-Jones, Donald, additional, Schreiner, Pamela, additional, Gidding, Samuel, additional, and Lima, Joao, additional

Published
2016
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36. Abstract 16614: Left Ventricular Global Function Index (A Novel Marker of Cardiac Performance) Predicts Incident Cardiovascular Events: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Author

Nwabuo, Chike C, primary, Mewton, Nathan, additional, Opdahl, Anders, additional, Moreira, Henrique T, additional, Ogunyankin, Kofo, additional, Ambale-Venkatesh, Bharath, additional, Schreiner, Pamela J, additional, Inoue, Yuko, additional, Ohyama, Yoshiaki, additional, Jacobs, David, additional, Lloyd-Jones, Donald, additional, Lewis, Beth, additional, Gidding, Samuel, additional, and Lima, João, additional

Published
2015
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37. GENDER AND RACE DIFFERENCES IN AGING-RELATED ALTERATION IN MYOCARDIAL SYSTOLIC FUNCTION ASSESSED BY 2D SPECKLE TRACKING ECHOCARDIOGRAPHY OVER A 20 YEAR FOLLOW-UP: THE CARDIA STUDY

Author

Nwabuo, Chike, primary, Choi, Eui-Young, additional, Venkatesh, Bharath Ambale, additional, Kishi, Satoru, additional, Almeida, Andre L., additional, Moreira, Henrique T., additional, Sharma, Ravi, additional, Armstrong, Anderson C., additional, Teixido, Gisela, additional, Gjesdal, Ola, additional, Lewis, Cora, additional, Sidney, Stephen, additional, Gidding, Samuel, additional, and Lima, Joao, additional

Published
2015
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39. Presence of scar by late gadolinium enhancement is a strong predictor of events in Chagas Heart Disease

Author

Volpe, Gustavo J, primary, Moreira, Henrique T, additional, Trad, Henrique S, additional, Wu, Katherine, additional, Braggion-Santos, Maria Fernanda, additional, Santos, Marcel Koenigkam, additional, Maciel, Benedito C, additional, Pazin, Antonio T, additional, Marin-Neto, José A, additional, Lima, Joao A, additional, and Schmidt, Andre, additional

Published
2014
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40. EVALUATION OF LATE GADOLINIUM ENHANCEMENT AND FUNCTIONAL PARAMETERS BY MRI AND EVENTS IN CHAGAS HEART DISEASE

Author

Volpe, Gustavo Jardim, primary, Moreira, Henrique T., additional, Trad, Henrique S., additional, Wu, Katherine C., additional, Santos, Maria Fernanda B., additional, Santos, Marcel K., additional, Maciel, Benedito C., additional, Neto, Jose Antonio Marin, additional, Bluemke, David A., additional, Lima, Joao A C, additional, and Schmidt, Andre, additional

Published
2013
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42. Abstract 12637: Temporal Changes in Resting Heart Rate in Young Adults, Long-term Cardiac Structure and Function, and Incident Heart Failure and Cardiovascular Disease in Middle Age

Author

Nwabuo, Chike C, Appiah, Duke, Moreira, Henrique T, Vasconcellos, Henrique D, Aghaji, Queen N, Ambale Venkatesh, Bharath, Rana, Jamal S, Allen, Norrina B, Lloyd-Jones, Donald M, Schreiner, Pamela, Gidding, Samuel, and Lima, Joao A

Abstract

Background:The prognostic significance of temporal changes in resting heart rate (RHR) in young adults for premature heart failure (HF) and cardiovascular disease (CVD) is not well-studied.Methods:We examined 4343 Coronary Artery Risk Development in Young Adults (CARDIA) Study participants aged 23-35 years(y) at Y5 (1990-1991) who had a contemporaneous assessment of RHR, echocardiograms, and long-term follow-up for outcomes. Cox proportional hazard models using single-occasion RHR (Y5) and temporal change in RHR (Y0 to Y5) as explanatory variables assessed associations with incident HF and CVD. Multivariable linear regression models were used to assess relations with CVD risk factors and cardiac structure and function.Results:Mean age was 29.9?3.6 years (Y5), 49% were Men, and 45% were African-American. There were 268 CVD events observed over a median follow-up of 26 years and 107991 person-years at risk. In Cox models, there was a near linear relation between temporal change in RHR and clinical outcomes. For each 1SD increment, longitudinal increases in RHR were associated with a higher risk of HF (HR=1.39 95% CI [1.09-1.78]) and CVD (HR=1.21 95% CI [1.06-1.37]). Temporal decreases in RHR were also associated with a lower risk of both HF and CVD. Single-occasion RHR was associated with CVD, but not with HF. Greater longitudinal increases in RHR were associated with higher alcohol consumption (?=0.03, p<0.001), lower physical activity (?=0.002, p=001), current smoking (? =1.58, p<0.001), Men (p<0.001), African-Americans (p<0.001), impaired left ventricular (LV) relaxation (e??= -0.13, p=0.002), and worse LV diastolic function (E/E? ? =0.1, p=0.01).Conclusions:Temporal changes in RHR in young adults were associated with incident HF and CVD in middle age and provided additional information to a single occasion RHR. Contributory factors were relations between secular changes in RHR and early suboptimal CVD risk factors and subsequent cardiac dysfunction.

Published
2019
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43. Abstract 12651: Long-term Cumulative Blood Pressure in Young Adults and Incident Heart Failure, Coronary Events, Stroke, Cardiovascular Disease, and Mortality: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Author

Nwabuo, Chike C, Appiah, Duke, Moreira, Henrique T, Vasconcellos, Henrique D, Yano, Yuichiro, Muntner, Paul, Reis, Jared P, Shah, Ravi V, Murthy, Venkatesh L, Allen, Norrina B, Sidney, Stephen, Lewis, Cora E, Lloyd-Jones, Donald M, Schreiner, Pamela, Gidding, Samuel, and Lima, Joao A

Abstract

Background:The prognostic utility of long-term cumulative blood pressure (BP) in young adults for premature cardiovascular disease (CVD) and mortality is uncertain.Methods:We investigated 3014 CARDIA participants aged 33-45 years(y) at Y15 (2000-2001), who attended 6 visits from Y0. Cox proportional hazard models were used to obtain relative hazards (HR) and 95% confidence intervals (CI) for cumulative (Y0 to Y15), single-occasion (Y15), and BP change (15y) measures and incident heart failure (HF), stroke, coronary heart disease (CHD), CVD, and mortality events. Models were adjusted for risk factors and time-varying BP medication use. C-statistics, category-free net reclassification index (NRI), and integrated discrimination improvement (IDI) were computedResults:Mean age at Y15 was 40.2?3.6y, 44.1% were men, and 44.1% were African-American. Over a median of 16y, subjects developed 144 CVD, 156 death, 54 stroke, 25 HF, and 81 CHD events. In Cox models (per SD increment)(table), cumulative systolic BP (SBP) was associated with HF (HR=2.42 95% CI [1.74-3.37]), stroke (HR=1.83 95% CI [1.39-2.41]), CHD (HR=1.48 95% CI [1.17-1.87]), CVD (HR=1.76 95% CI[1.49-2.09]), and mortality (HR=1.29 95% CI [1.09-1.54]). Cumulative DBP, Y15 SBP, and SBP change were similarly associated with adverse outcomes; albeit with lower magnitudes of association. For CVD, C-statistic for Y15 SBP was (0.70) in the base model and in incremental models adding SBP change or Cumulative SBP was (0.71 and 0.74), respectively. For CVD, using Y15 SBP as reference, NRI and IDI respectively for cumulative SBP was (0.39,standard error (SE) 0.08) and (0.02 SE 0.007) while NRI for SBP change was (0.22,SE 0.08) and IDI was non-significant.Conclusions:Cumulative BP across early adulthood was associated with incident HF, CHD, stroke, CVD, and mortality in middle age and provided incremental predictive value and improved risk reclassification when compared to a single-occasion or longitudinal BP change.

Published
2019
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45. Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study.

Author

Nwabuo CC, Moreira HT, Vasconcellos HD, Mewton N, Opdahl A, Ogunyankin KO, Ambale-Venkatesh B, Schreiner PJ, Armstrong AAC, Lewis CE, Jacobs DR, Lloyd-Jones D, Gidding SS, and Lima JAC

Subjects
Adolescent, Adult, Cardiovascular Diseases diagnostic imaging, Echocardiography, Female, Heart Failure diagnostic imaging, Heart Function Tests, Humans, Male, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Ventricular Dysfunction, Left diagnostic imaging, Cardiovascular Diseases physiopathology, Heart Failure physiopathology, Ventricular Dysfunction, Left physiopathology
Abstract

Aims: Left ventricular (LV) ejection fraction (LVEF) is an extensively utilized marker of LV function that is often interpreted without recourse to alterations in LV geometry and hypertrophy. LV global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance. We evaluated the prognostic utility of LVGFI from young adulthood into middle age for incident heart failure (HF) and cardiovascular disease (CVD) in comparison to LVEF., Methods and Results: Included were 4107 CARDIA participants with echocardiograms in Year-5 (1990-1991). LVGFI was defined as LV stroke volume/LV global volume*100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). Adjusted Cox proportional hazard models were utilized to predict incident HF and CVD outcomes. Mean age of participants was 29.8 ± 3.7 years, 55% female, and 48.7% black. Higher body mass index [beta coefficient (B) = -0.11 standard error (SE) = 0.02, P < 0.001], higher blood pressure (B = -0.04, SE = 0.01, P < 0.01), smoking (B = -0.82, SE = 0.22, P < 0.001), male sex (P < 0.001), and black race (P < 0.001) were associated with worse LVGFI. A total of 207 incident CVD events were observed over the course of 98 035 person-years at risk. Higher LVGFI was associated with HF, hazard ratio (HR) = 0.70, 95% confidence interval (CI) (0.54-0.91), hard CVD HR = 0.83, 95% CI (0.71-0.96), and all CVD HR = 0.83, 95% CI (0.72-0.96). For HF outcomes, Harrell's C-statistic for LVGFI (0.80) was greater than LVEF (0.66)., Conclusion: LVGFI is a strong, independent predictor of incident HF and CVD that provides incremental prognostic value compared with LVEF. Male sex, black race, obesity, hypertension, and smoking are associated with worse LVGFI in the early adult lifespan., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)

Published
2019
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46. Cumulative blood pressure from early adulthood to middle age is associated with left atrial remodelling and subclinical dysfunction assessed by three-dimensional echocardiography: a prospective post hoc analysis from the coronary artery risk development in young adults study.

Author

Vasconcellos HD, Moreira HT, Ciuffo L, Nwabuo CC, Yared GS, Ambale-Venkatesh B, Armstrong AC, Kishi S, Reis JP, Liu K, Lloyd-Jones DM, Colangelo LA, Schreiner PJ, Sidney S, Gidding SS, and Lima JAC

Subjects
Adult, Age Factors, Atrial Function, Left physiology, Atrial Remodeling physiology, Blood Pressure Determination methods, Coronary Artery Disease prevention & control, Female, Humans, Hypertension physiopathology, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Risk Assessment, Sensitivity and Specificity, Sex Factors, Systole, Young Adult, Blood Pressure physiology, Echocardiography, Three-Dimensional methods, Hypertension diagnostic imaging
Abstract

Aims: To evaluate the association of cumulative blood pressure (BP) from young adulthood to middle age with left atrial (LA) structure/function as assessed by three-dimensional echocardiography (3DE) in a large longitudinal bi-racial population study., Methods and Results: We conducted a prospective post hoc analysis of individuals enrolled at the Coronary Artery Risk Development in Young Adults, which is a multi-centre bi-racial cohort with 30 years of follow-up. Cumulative systolic and diastolic BP levels were defined by summing the product of average millimetres of mercury and the years between each two consecutive clinic visits over 30 years of follow-up. Multivariable linear regression analyses were used to assess the relationship between cumulative systolic and diastolic BP with 3DE LA structure and function, adjusting for demographics and traditional cardiovascular risk factors. A total of 1033 participants were included, mean age was 55.4 ± 3.5 years, 55.2% women, 43.9% blacks. Cumulative systolic BP had stronger correlations than cumulative diastolic BP. Higher cumulative systolic BP was independently associated with higher 3D LA volumes: maximum (β = 1.74, P = 0.004), pre-atrial contraction (β = 1.87, P < 0.001), minimum (β = 0.76, P = 0.04), total emptying (β = 0.98, P = 0.006), active emptying (β = 1.12, P < 0.001), and lower magnitude 3D LA early diastolic strain rate (β = 0.05, P = 0.02). Higher cumulative diastolic BP was independently associated with higher 3D LA active emptying volume (β = 0.66, P = 0.002), lower magnitude 3D LA early diastolic strain rate (β = 0.05, P = 0.004), and higher magnitude 3D LA late diastolic strain rate (β = -0.04, P = 0.05)., Conclusion: Higher cumulative BP from early adulthood throughout middle age was associated with adverse LA remodelling evaluated by 3D echocardiography.

Published
2018
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