Key result
Early-life BMI burden is linked to a ~4 g higher adult LV mass per SD.
Why the study?
Increased left ventricular mass predicts cardiovascular events and mortality, but whether early-life exposures to body mass index and systolic blood pressure affect adult left ventricular structure remained to be determined.
Does early-life high BMI increase left ventricular mass in adulthood?
Cohort (n=1,864)
Yes
Does early-life high BMI increase left ventricular mass in adulthood?
Mean Difference: 3.61 (95% CI 1.94–5.28)
p-value: p=<0.001
Primary prevention of obesity in early life may be crucial to prevent the development of high left ventricular mass and eccentric hypertrophy in adulthood.
Early-life BMI burden was associated with higher adult LVM; supports hypothesis-generating role for childhood obesity prevention but leaves causal impact open.
Background Increased left ventricular mass (LVM) predicts cardiovascular events and mortality. The objective of this study was to determine whether early-life exposures to body mass index (BMI) and systolic blood pressure (SPB) affects the left ventricular structure in adulthood.Methods We used longitudinal data from a 31-year follow-up to examine the associations between early-life (between ages 6–18) BMI and SPB on LVM in an adult population (N = 1864, aged 34–49). The burden of early-life BMI and SBP was defined as area under the curve.Results After accounting for contemporary adult determinants of LVM, early-life BMI burden associated significantly with LVM (3.61 g/SD increase in early-life BMI; [1.94 − 5.28], p < 0.001). Overweight in early-life (age- and sex-specific BMI values corresponding to adult BMI > 25 kg/m2) associated with 4.7% (2.5–6.9%, p < 0.0001) higher LVM regardless of BMI status in adulthood. Overweight in early-life combined with obesity in adulthood (BMI > 30kg/m2) resulted in a 21% (17.3–32.9%, p < 0.0001) increase in LVM. Higher early-life BMI was associated with a risk of developing eccentric hypertrophy. The burden of early-life SPB was not associated with adult LVM or left ventricular remodeling.Conclusions High BMI in early-life confers a sustained effect on LVM and the risk for eccentric hypertrophy independently of adulthood risk factors.KEY MESSAGESExcess in BMI in early-life has an independent effect on LVM and the risk of developing eccentric hypertrophy regardless of overweight status in adulthood.Systolic blood pressure levels in early-life did not have an independent effect on LVM or LV remodeling.The clinical implication of this study is that primary prevention of obesity in early-life may prevent the development of high LVM and eccentric hypertrophy.
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Heiskanen et al. (2020) conducted a cohort in Left ventricular mass and remodeling (n=1,864). Early-life body mass index (BMI) vs. Lower early-life BMI was evaluated on Left ventricular mass (LVM) (3.61 g/SD increase, 95% CI 1.94-5.28, p=<0.001). Early-life BMI burden was significantly associated with higher adult left ventricular mass (3.61 g per SD increase) independently of adulthood risk factors.
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