Association between subclinical atherosclerosis and cardiac structure and function—results from the UK Biobank Study

Author:

Simon Judit12ORCID,Fung Kenneth34ORCID,Raisi-Estabragh Zahra34,Aung Nay34ORCID,Khanji Mohammed Y345,Zsarnóczay Emese12,Merkely Béla2,Munroe Patricia B3,Harvey Nicholas C6ORCID,Piechnik Stefan K7,Neubauer Stefan7ORCID,Leeson Paul8,Petersen Steffen E34,Maurovich-Horvat Pál12

Affiliation:

1. MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University , Üllői út 78, H-1082 Budapest , Hungary

2. Heart and Vascular Center, Semmelweis University , Budapest, Hungary, Városmajor u 68, H-1122 Budapest , Hungary

3. William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London , London EC1M 6BQ , United Kingdom

4. Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust , West Smithfield, London EC1A 7BE , United Kingdom

5. Barts Health NHS Trust, Newham University Hospital , Glen Road, Plaistow, London E1 1BB , United Kingdom

6. MRC Lifecourse Epidemiology Unit, University of Southampton , Southampton SO16 6YD , United Kingdom

7. National Institute for Health Research, Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford , Oxford OX3 9DU , United Kingdom

8. Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 1, John Radcliffe Hospital , Oxford OX3 9DU , United Kingdom

Abstract

Abstract Aims Heart failure (HF) is a major health problem and early diagnosis is important. Atherosclerosis is the main cause of HF and carotid intima-media thickness (IMT) is a recognized early measure of atherosclerosis. This study aimed to investigate whether increased carotid IMT is associated with changes in cardiac structure and function in middle-aged participants of the UK Biobank Study without overt cardiovascular disease. Methods and results Participants of the UK Biobank who underwent CMR and carotid ultrasound examinations were included in this study. Patients with heart failure, angina, atrial fibrillation, and history of myocardial infarction or stroke were excluded. We used multivariable linear regression models adjusted for age, sex, physical activity, body mass index, body surface area, hypertension, diabetes, smoking, ethnicity, socioeconomic status, alcohol intake, and laboratory parameters. In total, 4301 individuals (61.6 ± 7.5 years, 45.9% male) were included. Multivariable linear regression analyses showed that increasing quartiles of IMT was associated with increased left and right ventricular (LV and RV) and left atrial volumes and greater LV mass. Moreover, increased IMT was related to lower LV end-systolic circumferential strain, torsion, and both left and right atrial ejection fractions (all P < 0.05). Conclusion Increased IMT showed an independent association over traditional risk factors with enlargement of all four cardiac chambers, decreased function in both atria, greater LV mass, and subclinical LV dysfunction. There may be additional risk stratification that can be derived from the IMT to identify those most likely to have early cardiac structural/functional changes.

Funder

National Institute for Health Research

Barts Biomedical Research Centre

SmartHeart

CAP-AI programme

European Regional Development Fund

Barts Charity

Oxford NIHR Biomedical Research Centre

Oxford British Heart Foundation Centre of Research Excellence

Academic Clinical Lectureship Post

UK Medical Research Council

NIHR Southampton Biomedical Research Centre

University of Southampton

British Heart Foundation

National Research, Development and Innovation Fund of Hungary

Thematic Excellence Programme

Ministry for Innovation and Technology in Hungary

Publisher

Oxford University Press (OUP)

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