具有久坐生活方式相关风险因素的年轻成年人3T磁共振成像中的心脏改变
Cardiac Alterations on 3T MRI in Young Adults With Sedentary Lifestyle-Related Risk Factors.
作者信息
Snel Gert J H, van den Boomen Maaike, Hurtado-Ortiz Katia, Slart Riemer H J A, van Deursen Vincent M, Nguyen Christopher T, Sosnovik David E, Dierckx Rudi A J O, Velthuis Birgitta K, Borra Ronald J H, Prakken Niek H J
机构信息
Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
出版信息
Front Cardiovasc Med. 2022 Feb 22;9:840790. doi: 10.3389/fcvm.2022.840790. eCollection 2022.
BACKGROUND
Young adult populations with the sedentary lifestyle-related risk factors overweight, hypertension, and type 2 diabetes (T2D) are growing, and associated cardiac alterations could overlap early findings in non-ischemic cardiomyopathy on cardiovascular MRI. We aimed to investigate cardiac morphology, function, and tissue characteristics for these cardiovascular risk factors.
METHODS
Non-athletic non-smoking asymptomatic adults aged 18-45 years were prospectively recruited and underwent 3Tesla cardiac MRI. Multivariate linear regression was performed to investigate independent associations of risk factor-related parameters with cardiac MRI values.
RESULTS
We included 311 adults (age, 32 ± 7 years; men, 49%). Of them, 220 subjects had one or multiple risk factors, while 91 subjects were free of risk factors. For overweight, increased body mass index (per SD = 5.3 kg/m) was associated with increased left ventricular (LV) mass (+7.3 g), biventricular higher end-diastolic (LV, +8.6 ml), and stroke volumes (SV; +5.0 ml), higher native T (+7.3 ms), and lower extracellular volume (ECV, -0.38%), whereas the higher waist-hip ratio was associated with lower biventricular volumes. Regarding hypertension, increased systolic blood pressure (per SD = 14 mmHg) was associated with increased LV mass (+6.9 g), higher LV ejection fraction (EF; +1.0%), and lower ECV (-0.48%), whereas increased diastolic blood pressure was associated with lower LV EF. In T2D, increased HbA1c (per SD = 9.0 mmol/mol) was associated with increased LV mass (+2.2 g), higher right ventricular end-diastolic volume (+3.2 ml), and higher ECV (+0.27%). Increased heart rate was linked with decreased LV mass, lower biventricular volumes, and lower T values.
CONCLUSIONS
Young asymptomatic adults with overweight, hypertension, and T2D show subclinical alterations in cardiac morphology, function, and tissue characteristics. These alterations should be considered in cardiac MRI-based clinical decision making.
背景
患有与久坐生活方式相关的超重、高血压和2型糖尿病（T2D）等危险因素的年轻成年人群正在增加，并且相关的心脏改变可能与心血管磁共振成像（MRI）上非缺血性心肌病的早期表现重叠。我们旨在研究这些心血管危险因素的心脏形态、功能和组织特征。
方法
前瞻性招募年龄在18至45岁之间、非运动、不吸烟的无症状成年人，并对其进行3特斯拉心脏MRI检查。进行多变量线性回归以研究危险因素相关参数与心脏MRI值之间的独立关联。
结果
我们纳入了311名成年人（年龄32±7岁；男性占49%）。其中，220名受试者有一个或多个危险因素，而91名受试者没有危险因素。对于超重，体重指数增加（每标准差=5.3kg/m²）与左心室（LV）质量增加（+7.3g）、双心室舒张末期容积增加（LV，+8.6ml）和每搏输出量（SV；+5.0ml）增加、固有T2值升高（+7.3ms）以及细胞外容积降低（ECV，-0.38%）相关，而腰臀比升高与双心室容积降低相关。关于高血压，收缩压升高（每标准差=14mmHg）与LV质量增加（+6.9g）、LV射血分数（EF）升高（+1.0%）和ECV降低（-0.48%）相关，而舒张压升高与LV EF降低相关。在T2D中，糖化血红蛋白（HbA1c）升高（每标准差=9.0mmol/mol）与LV质量增加（+2.2g）、右心室舒张末期容积增加（+3.2ml）和ECV升高（+0.27%）相关。心率增加与LV质量降低、双心室容积降低和T2值降低有关。
结论
患有超重、高血压和T２D的年轻无症状成年人在心脏形态、功能和组织特征方面存在亚临床改变。在基于心脏MRI的临床决策中应考虑这些改变。
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