Laitinen Tomi T, Ruohonen Saku, Juonala Markus, Magnussen Costan G, Mikkilä Vera, Mikola Hanna, Hutri-Kähönen Nina, Laitinen Tomi, Tossavainen Päivi, Jokinen Eero, Niinikoski Harri, Jula Antti, Viikari Jorma S A, Rönnemaa Tapani, Raitakari Olli T, Pahkala Katja
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Int J Cardiol. 2017 Mar 1;230:304-309. doi: 10.1016/j.ijcard.2016.12.117. Epub 2016 Dec 23.
Ideal cardiovascular health (CVH), defined by the American Heart Association, is associated with incident cardiovascular disease in adults. However, association of the ideal CVH in childhood with current and future cardiac structure and function has not been studied.
The sample comprised 827 children participating in the longitudinal Special Turku Coronary Risk Factor Intervention Project (STRIP) and The Cardiovascular Risk in Young Finns Study (YFS). In STRIP, complete data on the seven ideal CVH metrics and left ventricular (LV) mass measured with echocardiography were available at the age of 15 (n=321), 17 (n=309) and 19 (n=283) years. In YFS, the cohort comprised children aged 12-18years (n=506) with complete ideal CVH metrics data from childhood and 25years later in adulthood, and echocardiography performed in adulthood. In STRIP, ideal CVH score was inversely associated with LV mass during childhood (P=0.036). In YFS, childhood ideal CVH score was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume in adulthood (all P<0.01). In addition, improvement of the ideal CVH score between childhood and adulthood was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume (all P≤0.03).
Childhood ideal CVH score has a long-lasting effect on cardiac structure and function, and the association is evident already in childhood. Our findings support targeting the ideal CVH metrics as part of primordial prevention of cardiovascular diseases.
美国心脏协会定义的理想心血管健康（CVH）与成人心血管疾病的发生相关。然而，儿童期理想CVH与当前及未来心脏结构和功能的关联尚未得到研究。
样本包括827名参与纵向的图尔库特殊冠心病危险因素干预项目（STRIP）和芬兰青年人心血管风险研究（YFS）的儿童。在STRIP中，可获得15岁（n = 321）、17岁（n = 309）和19岁（n = 283）时关于七个理想CVH指标以及通过超声心动图测量的左心室（LV）质量的完整数据。在YFS中，队列包括12至18岁的儿童（n = 506），他们在儿童期有完整的理想CVH指标数据，并在25年后成年期进行了超声心动图检查。在STRIP中，理想CVH评分与儿童期LV质量呈负相关（P = 0.036）。在YFS中，儿童期理想CVH评分与成年期LV质量、左心室舒张末期容积、E/e'比值和左心房收缩末期容积呈负相关（均P < 0.01）。此外，儿童期至成年期理想CVH评分的改善与LV质量、左心室舒张末期容积、E/e'比值和左心房收缩末期容积呈负相关（均P≤0.03）。
儿童期理想CVH评分对心脏结构和功能有长期影响，且这种关联在儿童期就已明显。我们的研究结果支持将理想CVH指标作为心血管疾病一级预防的一部分。
