1 Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
2 Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
Eur J Prev Cardiol. 2017 Sep;24(13):1408-1415. doi: 10.1177/2047487317715512. Epub 2017 Jun 12.
Objective Cardiac structure and function are important predictors for cardiovascular disease in adults. Not much is known about tracking of cardiac measures, other than left ventricular mass, from early life onwards. We examined whether and to what extent cardiac measures track from infancy into school-age. Methods We performed a population-based prospective cohort study among 1072 children. Aortic root diameter, left atrial diameter, left ventricular mass, relative wall thickness and fractional shortening were measured repeatedly by echocardiography. We explored tracking between infancy (1.5, six and 24 months) and school-age (six and 10 years). Results Of all cardiac measures, aortic root diameter, left atrial diameter and left ventricular mass were significantly correlated between infancy and school-age ( r = 0.10-0.42, all p-values < 0.01), with the strongest correlations between 24 months and 10 years. Of the different structures, aortic root diameter showed the strongest correlations. Approximately 30% of children who were in the lowest or highest quartile of a measure at the age of 1.5 months remained in that quartile at the age of 10 years. When analysing the effects of the infant cardiac measures on the same outcomes at 10 years in conditional regression models, we observed effect estimates of the same size for the different age windows. Conclusion Our results suggest moderate tracking of structural cardiac measures from early infancy until school-age, which become stronger at older ages, but not of relative wall thickness or fractional shortening. Moderate tracking of cardiac structures suggests that cardiac structures are at least partly determined in early life.
目的
心脏结构和功能是成人心血管疾病的重要预测指标。人们对心脏指标的跟踪，除了左心室质量以外，从婴儿期到成年期的了解甚少。我们研究了心脏指标是否以及在何种程度上从婴儿期一直跟踪到学龄期。
方法
我们在 1072 名儿童中进行了一项基于人群的前瞻性队列研究。通过超声心动图多次测量主动脉根部直径、左心房直径、左心室质量、相对壁厚度和分数缩短率。我们探讨了婴儿期（1.5、6 和 24 个月）和学龄期（6 和 10 岁）之间的跟踪情况。
结果
在所有心脏指标中，主动脉根部直径、左心房直径和左心室质量在婴儿期和学龄期之间具有显著相关性（r=0.10-0.42，均 P 值<0.01），其中 24 个月和 10 岁之间的相关性最强。在不同的结构中，主动脉根部直径显示出最强的相关性。大约 30%的儿童在 1.5 个月时处于某一指标的最低或最高四分位数，在 10 岁时仍处于该四分位数。在条件回归模型中分析婴儿心脏指标对 10 岁时相同结果的影响时，我们观察到不同年龄窗口的效应估计值大小相同。
结论
我们的研究结果表明，从婴儿早期到学龄期，心脏结构的跟踪程度适中，随着年龄的增长而增强，但相对壁厚度或分数缩短率没有跟踪。心脏结构的适度跟踪表明，心脏结构至少在一定程度上是在生命早期确定的。
