Key result
High-risk multivariable cardiovascular risk factor trajectory clusters over 14 years were associated with worse cardiac function, including a significant decrease in left ventricular stroke volume (β = -7.00 ml/m2) compared to low-risk clusters.
Why the study?
The association between longitudinal trajectories of cardiovascular risk factors and CMR-derived measures of cardiac structure and function in the community is not well known.
Does higher cumulative exposure to cardiovascular risk factors over 14 years worsen CMR-derived cardiac structure and function in a population-based cohort?
Cohort (n=349)
Does higher cumulative exposure to cardiovascular risk factors over 14 years worsen CMR-derived cardiac structure and function in a population-based cohort?
Mean Difference: -7 (95% CI -10.73–-3.28)
p-value: p=<0.001
High-risk trajectories were associated with lower LV stroke volume on CMR; leaves open causal effects and need for prospective trials.
The association of longitudinal trajectories of cardiovascular risk factors with cardiovascular magnetic resonance (CMR)-measures of cardiac structure and function in the community is not well known. Therefore we aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort. We assessed conventional cardiovascular disease risk factors in 349 participants (143 women; aged 25–59 years) at three examination cycles (Exam 1 [baseline], at Exam 2 [7-years follow-up] and at Exam 3 [14-years follow-up]) of the KORA S4 cohort and related single-point measurements of individual risk factors and longitudinal trajectories of these risk factors to various CMR-measures obtained at Exam 3. High levels of diastolic blood pressure, waist circumference, and LDL-cholesterol at the individual exams were associated with worse cardiac function and structure. Trajectory clusters representing higher levels of the individual risk factors were associated with worse cardiac function and structure compared to low risk trajectory clusters of individual risk factors. Multivariable (combining different risk factors) trajectory clusters were associated with different cardiac parameters in a graded fashion (e.g. decrease of LV stroke volume for middle risk cluster β = − 4.91 ml/m2, 95% CI − 7.89; − 1.94, p < 0.01 and high risk cluster β = − 7.00 ml/m2, 95% CI − 10.73; − 3.28, p < 0.001 compared to the low risk cluster). The multivariable longitudinal trajectory clusters added significantly to explain variation in CMR traits beyond the multivariable risk profile obtained at Exam 3. Cardiovascular disease risk factor levels, measured over a time period of 14 years, were associated with CMR-derived measures of cardiac structure and function. Longitudinal multivariable trajectory clusters explained a greater proportion of the inter-individual variation in cardiac traits than multiple risk factor assessed contemporaneous with the CMR exam.
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Lorbeer et al. (2021) conducted a cohort in General population (n=349). High-risk multivariable cardiovascular risk factor trajectory clusters vs. Low-risk multivariable trajectory cluster was evaluated on Left ventricular stroke volume (β = -7.00 ml/m2, 95% CI -10.73; -3.28, p=<0.001). High-risk multivariable cardiovascular risk factor trajectory clusters over 14 years were associated with worse cardiac function, including a significant decrease in left ventricular stroke volume (β = -7.00 ml/m2) compared to low-risk clusters.
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