Journal Article

The impact of cardiovascular risk factors on cardiac structure and function: Insights from the UK Biobank imaging enhancement study

Sanghvi, Mihir M., Neubauer, Stefan, Paiva, José Miguel, Kim, Young Jin, Carapella, Valentina, Fung, Kenneth, Petersen, Steffen E., Piechnik, Stefan K., Aung, Nay, Lee, Aaron M., Cooper, Jackie A., Zemrak, Filip, Lukaschuk, Elena

2017

Overview

The UK Biobank is a large-scale population-based study utilising cardiovascular magnetic resonance (CMR) to generate measurements of atrial and ventricular structure and function. This study aimed to quantify the association between modifiable cardiovascular risk factors and cardiac morphology and function in individuals without known cardiovascular disease. Age, sex, ethnicity (non-modifiable) and systolic blood pressure, diastolic blood pressure, smoking status, exercise, body mass index (BMI), high cholesterol, diabetes, alcohol intake (modifiable) were considered important cardiovascular risk factors. Multivariable regression models were built to ascertain the association of risk factors on left ventricular (LV), right ventricular (RV), left atrial (LA) and right atrial (RA) CMR parameters. 4,651 participants were included in the analysis. All modifiable risk factors had significant effects on differing atrial and ventricular parameters. BMI was the modifiable risk factor most consistently associated with subclinical changes to CMR parameters, particularly in relation to higher LV mass (+8.3% per SD [4.3 kg/m2], 95% CI: 7.6 to 8.9%), LV (EDV: +4.8% per SD, 95% CI: 4.2 to 5.4%); ESV: +4.4% per SD, 95% CI: 3.5 to 5.3%), RV (EDV: +5.3% per SD, 95% CI: 4.7 to 5.9%; ESV: +5.4% per SD, 95% CI: 4.5 to 6.4%) and LA maximal (+8.6% per SD, 95% CI: 7.4 to 9.7%) volumes. Increases in SBP were associated with higher LV mass (+6.8% per SD, 95% CI: 5.9 to 7.7%), LV (EDV: +4.5% per SD, 95% CI: 3.6 to 5.4%; ESV: +2.0% per SD, 95% CI: 0.8 to 3.3%) volumes. The presence of diabetes or high cholesterol resulted in smaller volumes and lower ejection fractions. Modifiable risk factors are associated with subclinical alterations in structure and function in all four cardiac chambers. BMI and systolic blood pressure are the most important modifiable risk factors affecting CMR parameters known to be linked to adverse outcomes.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adults / Aged / Alcoholic beverages / Biological Specimen Banks / Biology and Life Sciences / Biomedical research / Blood / Blood pressure / Body mass / Body Mass Index / Cardiovascular disease / Cardiovascular diseases / Cholesterol / Coronary vessels / Diabetes / Diabetes mellitus / Female / Health aspects / Health risk assessment / Health risks / Heart - anatomy & histology / Heart - diagnostic imaging / Heart - physiology / Heart attacks / Heart diseases / Heart failure / Humans / Magnetic resonance / Male / Measurement / Medicine / Medicine and Health Sciences / Middle Aged / Minority & ethnic groups / Mortality / Parameter modification / Physical Sciences / Population studies / Radiographic Image Enhancement - methods / Regression analysis / Regression models / Risk analysis / Risk Factors / Smoking / Structure-function relationships / United Kingdom / Ventricle