Department of Radiology, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany.
J Cardiovasc Magn Reson. 2021 Jan 4;23(1):2. doi: 10.1186/s12968-020-00698-w.
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/m, 95% CI - 7.89; - 1.94, p < 0.01 and high risk cluster β = - 7.00 ml/m, 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.
心血管危险因素的纵向变化轨迹与社区人群心血管磁共振（CMR）检测的心脏结构和功能之间的关系尚不清楚。因此，我们旨在通过基于人群的队列研究，将不同检查周期的危险因素水平与 CMR 检测的左心室（LV）和右心室（RV）测量值相关联。
我们在 KORA S4 队列的三个检查周期（检查 1[基线]、检查 2[7 年随访]和检查 3[14 年随访]）中评估了 349 名参与者（143 名女性；年龄 25-59 岁）的常规心血管疾病危险因素，并将个体危险因素的单点测量值和这些危险因素的纵向变化轨迹与检查 3 时获得的各种 CMR 测量值相关联。
个体检查中舒张压、腰围和 LDL 胆固醇水平较高与心脏功能和结构较差有关。与个体危险因素的低风险轨迹簇相比，代表个体危险因素水平较高的轨迹簇与心脏功能和结构较差相关。多变量（合并不同危险因素）轨迹簇以分级方式与不同的心脏参数相关（例如，中间风险簇的 LV 收缩量减少β=-4.91ml/m，95%CI-7.89；-1.94，p<0.01，高风险簇β=-7.00ml/m，95%CI-10.73；-3.28，p<0.001与低风险簇相比）。多变量纵向轨迹簇在解释 CMR 特征的个体间差异方面比检查 3 时获得的多变量风险特征更有意义。
在 14 年的时间内测量心血管疾病危险因素水平与 CMR 检测的心脏结构和功能指标相关。纵向多变量轨迹簇比与 CMR 检查同时评估的多个危险因素更能解释心脏特征个体间变异的更大比例。
