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Longitudinal Associations of Fitness and Obesity in Young Adulthood With Right Ventricular Function and Pulmonary Artery Systolic Pressure in Middle Age: The CARDIA Study.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2021 Apr 06; Vol. 10 (7), pp. e016968. Date of Electronic Publication: 2021 Mar 28. - Publication Year :
- 2021
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Abstract
- Background Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. Methods and Results Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow-up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow-up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable-adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow-up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. Conclusions Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with better RV systolic function. Higher baseline BMI and greater age-related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.
- Subjects :
- Blood Pressure
Body Mass Index
Echocardiography, Doppler methods
Exercise Test methods
Female
Heart Disease Risk Factors
Humans
Longitudinal Studies
Male
Middle Aged
Risk Assessment methods
United States epidemiology
Young Adult
Cardiorespiratory Fitness physiology
Heart Failure diagnosis
Heart Failure epidemiology
Heart Failure physiopathology
Obesity diagnosis
Obesity epidemiology
Obesity physiopathology
Pulmonary Artery physiopathology
Ventricular Dysfunction, Right diagnostic imaging
Ventricular Dysfunction, Right physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 10
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 33775106
- Full Text :
- https://doi.org/10.1161/JAHA.120.016968