Key result
High BMI at age 40 linked to increased mechanical dispersion and higher hs-cTnT decades later.
Why the study?
Associations between left ventricular mechanical dispersion, early mid-life cardiovascular risk factors, and established biomarkers of sub-clinical myocardial injury and dysfunction are not known in the general population.
Are cardiovascular risk factors in early mid-life associated with left ventricular mechanical dispersion two decades later, and does mechanical dispersion correlate cross-sectionally with biomarkers of subclinical myocardial injury?
Cohort (n=2,527)
Yes
Are cardiovascular risk factors in early mid-life associated with left ventricular mechanical dispersion two decades later, and does mechanical dispersion correlate cross-sectionally with biomarkers of subclinical myocardial injury?
Left ventricular mechanical dispersion may serve as an early echocardiographic index of subclinical myocardial injury, with its progression potentially influenced by common cardiovascular risk factors present in early adulthood.
Early mid-life BMI was associated with later mechanical dispersion and hs-cTnT; hypothesis-generating for preventive strategies, with trials needed before practice change.
Aims: Mechanical dispersion measures left ventricular contraction heterogeneity and is associated with the risk of sudden cardiac death. However, the associations between mechanical dispersion and cardiovascular risk factors in early mid-life, and established biomarkers of sub-clinical myocardial injury and dysfunction are not known. We aimed to examine this in the general population. Methods and results: During 2012-15, we included 2527 Norwegian individuals from the general population born in 1950, with measurements of mechanical dispersion by 2D speckle tracking echocardiography and concentrations of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) available. Mechanical dispersion was calculated as the standard deviation of the contraction duration of 17 strain segments. We assessed the associations between mechanical dispersion, concentrations of hs-cTnT and NT-proBNP, and cardiovascular risk factors collected at a national health screening survey two decades earlier. At echocardiography baseline, median age was 64 (interquartile range 63.5-64.5) years, 49.8% were women, 59.1% had hypertension, and 5.9% reported established coronary artery disease. Median mechanical dispersion was 38.0 (29.5-47.0) ms, median hs-cTnT concentration 6 (4-8) ng/L, and the median NT-proBNP concentration 54 (34-93) ng/L. Mechanical dispersion was associated with both hs-cTnT and NT-proBNP concentrations in multivariable models adjusted for clinical and echocardiographic variables. High body mass index, serum triglyceride concentrations, and low resting heart rate at Age 40 were independently associated with increased mechanical dispersion two decades later. Conclusion: Established risk factors at Age 40 are associated with mechanical dispersion two decades later, and mechanical dispersion is cross-sectionally associated with biomarkers of subclinical myocardial injury and dysfunction.
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Aagaard et al. (2022) conducted a cohort in General population without established cardiovascular disease criteria (n=2,527). Left ventricular mechanical dispersion was evaluated on High-sensitivity cardiac troponin T (hs-cTnT) concentration (beta 0.029 (per 10 ms increase in mechanical dispersion), 95% CI 0.015-0.043, p=<0.001). High BMI at age 40 was independently associated with increased mechanical dispersion two decades later (B 0.35, p=0.005), which in turn cross-sectionally correlated with higher hs-cTnT concentrations (B 0.029, p<0.001).
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