Quiroz Juan C, Cooper Jackie, McCracken Celeste, Khanji Mohammed Y, Laranjo Liliana, Aung Nay, Lee Aaron Mark, Simon Judit, Murphy Theodore, Biasiolli Luca, Piechnik Stefan K, Maurovich-Horvat Pal, Petersen Steffen E, Raisi-Estabragh Zahra
Centre for Big Data Research in Health (CBDRH), The University of New South Wales (UNSW), Level 2, AGSM Building G27, Botany St, Kensington, NSW 2033, Australia.
William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
Eur Heart J Imaging Methods Pract. 2024 Dec 19;2(3):qyae139. doi: 10.1093/ehjimp/qyae139. eCollection 2024 Jul.
The importance of early life factors in determining health in later adulthood is increasingly recognized. This study evaluated the association of adverse childhood experiences (ACEs) with cardiovascular magnetic resonance (CMR) phenotypes.
UK Biobank participants who had completed CMR and the self-reported questionnaire on traumatic childhood experiences were included. Images were analysed using automated pipelines to extract measures of left and right ventricular (LV and RV) structure and function, myocardial character, and arterial compliance. Multivariable linear regression was used to estimate the association of childhood adversity with CMR phenotypes adjusting for age, sex, deprivation, education, obesity, smoking, alcohol intake, exercise level, diabetes, hypertension, and hypercholesterolaemia. Amongst 30 814 participants analysed, 6023 (19.5%) experienced physical abuse, 2746 (8.9%) sexual abuse, 4685 (15.2%) emotional abuse, 6822 (22.1%) emotional neglect, and 4534 (14.7%) physical neglect. Except for physical abuse, women reported greater rates of childhood adversity than men. Collectively, all types of childhood adversity were associated with smaller LV and RV volumes, greater LV mass, a concentric pattern of LV remodelling, poorer LV and RV function, lower aortic compliance, and greater arterial stiffness. Sexual abuse was associated with unhealthy CMR phenotypes in age- and sex-adjusted models, but these relationships were attenuated in fully adjusted models. Physical neglect had the most prominent pattern of adverse cardiovascular remodelling.
ACEs were associated with unhealthy cardiovascular remodelling in adulthood, independent of traditional cardiovascular risk factors. These findings support the consideration of early life factors in cardiovascular disease risk assessment.
人们越来越认识到早期生活因素在决定成年后期健康方面的重要性。本研究评估了童年不良经历（ACEs）与心血管磁共振（CMR）表型之间的关联。
纳入了完成CMR检查以及关于童年创伤经历的自我报告问卷的英国生物银行参与者。使用自动化流程分析图像，以提取左心室和右心室（LV和RV）结构与功能、心肌特征以及动脉顺应性的测量值。采用多变量线性回归来估计童年逆境与CMR表型之间的关联，并对年龄、性别、贫困程度、教育程度、肥胖、吸烟、饮酒量、运动水平、糖尿病、高血压和高胆固醇血症进行了校正。在分析的30814名参与者中，6023人（19.5%）遭受过身体虐待，2746人（8.9%）遭受过性虐待，4685人（15.2%）遭受过情感虐待，6822人（22.1%）遭受过情感忽视，4534人（14.7%）遭受过身体忽视。除身体虐待外，女性报告的童年逆境发生率高于男性。总体而言，所有类型的童年逆境都与较小的左心室和右心室容积、更大的左心室质量、左心室重塑的同心模式、较差的左心室和右心室功能、较低的主动脉顺应性以及更大的动脉僵硬度相关。在年龄和性别校正模型中，性虐待与不健康的CMR表型相关，但在完全校正模型中，这些关系减弱。身体忽视具有最显著的不良心血管重塑模式。
ACEs与成年期不健康的心血管重塑相关，独立于传统心血管危险因素。这些发现支持在心血管疾病风险评估中考虑早期生活因素。
