Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study

Kershaw V. Patel; Mark Metzinger; Bryan Park; Norrina Allen; Colby Ayers; Steven M. Kawut; Stephen Sidney; David C. Goff; David R. Jacobs; Ahmed F. Zaky; Mercedes Carnethon; Jarett D. Berry; Ambarish Pandey

doi:10.1161/JAHA.120.016968

Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study

Kershaw V. Patel, Mark Metzinger, Bryan Park, Norrina Allen, Colby Ayers, Steven M. Kawut, Stephen Sidney, David C. Goff, David R. Jacobs, Ahmed F. Zaky, Mercedes Carnethon, Jarett D. Berry, Ambarish Pandey

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. METHODS AND RESULTS: Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow-up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow-up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable-adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow-up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. CONCLUSIONS: Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with bet-ter RV systolic function. Higher baseline BMI and greater age-related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.

Original language	English (US)
Article number	e016968
Journal	Journal of the American Heart Association
Volume	10
Issue number	7
DOIs	https://doi.org/10.1161/JAHA.120.016968
State	Published - 2021

Bibliographical note

Funding Information:
Dr Patel is supported by the NHLBI T32 postdoctoral training grant (5T32HL125247). Dr Kawut is supported by National Institutes of Health K24HL103844. Dr Berry received funding from 14SFRN20740000 from the American Heart Association Prevention Network. Dr Pandey has received research support from Texas Health Resources Clinical Scholarship, the Gilead Sciences Research Scholar Program, the National Institute of Aging GEMSSTAR grant (1R03AG067960-01), and Applied Therapeutics. The CARDIA study is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I).

Publisher Copyright:
© 2021 The Authors.

Keywords

Body mass index
Fitness
Pulmonary artery systolic pressure
Right ventricular function

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1161/JAHA.120.016968

Find It

Find It at U of M Libraries

Cite this

Patel, K. V., Metzinger, M., Park, B., Allen, N., Ayers, C., Kawut, S. M., Sidney, S., Goff, D. C., Jacobs, D. R., Zaky, A. F., Carnethon, M., Berry, J. D., & Pandey, A. (2021). Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study. Journal of the American Heart Association, 10(7), Article e016968. https://doi.org/10.1161/JAHA.120.016968

Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study. / Patel, Kershaw V.; Metzinger, Mark; Park, Bryan et al.
In: Journal of the American Heart Association, Vol. 10, No. 7, e016968, 2021.

Research output: Contribution to journal › Article › peer-review

Patel, KV, Metzinger, M, Park, B, Allen, N, Ayers, C, Kawut, SM, Sidney, S, Goff, DC, Jacobs, DR, Zaky, AF, Carnethon, M, Berry, JD & Pandey, A 2021, 'Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study', Journal of the American Heart Association, vol. 10, no. 7, e016968. https://doi.org/10.1161/JAHA.120.016968

@article{337220833b6d4554922e67909cadf2db,

title = "Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study",

abstract = "BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. METHODS AND RESULTS: Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow-up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow-up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable-adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow-up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. CONCLUSIONS: Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with bet-ter RV systolic function. Higher baseline BMI and greater age-related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.",

keywords = "Body mass index, Fitness, Pulmonary artery systolic pressure, Right ventricular function",

author = "Patel, {Kershaw V.} and Mark Metzinger and Bryan Park and Norrina Allen and Colby Ayers and Kawut, {Steven M.} and Stephen Sidney and Goff, {David C.} and Jacobs, {David R.} and Zaky, {Ahmed F.} and Mercedes Carnethon and Berry, {Jarett D.} and Ambarish Pandey",

note = "Funding Information: Dr Patel is supported by the NHLBI T32 postdoctoral training grant (5T32HL125247). Dr Kawut is supported by National Institutes of Health K24HL103844. Dr Berry received funding from 14SFRN20740000 from the American Heart Association Prevention Network. Dr Pandey has received research support from Texas Health Resources Clinical Scholarship, the Gilead Sciences Research Scholar Program, the National Institute of Aging GEMSSTAR grant (1R03AG067960-01), and Applied Therapeutics. The CARDIA study is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Publisher Copyright: {\textcopyright} 2021 The Authors.",

year = "2021",

doi = "10.1161/JAHA.120.016968",

language = "English (US)",

volume = "10",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "American Heart Association Inc.",

number = "7",

}

TY - JOUR

T1 - Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age

T2 - The cardia study

AU - Patel, Kershaw V.

AU - Metzinger, Mark

AU - Park, Bryan

AU - Allen, Norrina

AU - Ayers, Colby

AU - Kawut, Steven M.

AU - Sidney, Stephen

AU - Goff, David C.

AU - Jacobs, David R.

AU - Zaky, Ahmed F.

AU - Carnethon, Mercedes

AU - Berry, Jarett D.

AU - Pandey, Ambarish

N1 - Funding Information: Dr Patel is supported by the NHLBI T32 postdoctoral training grant (5T32HL125247). Dr Kawut is supported by National Institutes of Health K24HL103844. Dr Berry received funding from 14SFRN20740000 from the American Heart Association Prevention Network. Dr Pandey has received research support from Texas Health Resources Clinical Scholarship, the Gilead Sciences Research Scholar Program, the National Institute of Aging GEMSSTAR grant (1R03AG067960-01), and Applied Therapeutics. The CARDIA study is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Publisher Copyright: © 2021 The Authors.

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. METHODS AND RESULTS: Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow-up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow-up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable-adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow-up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. CONCLUSIONS: Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with bet-ter RV systolic function. Higher baseline BMI and greater age-related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.

AB - BACKGROUND: Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. METHODS AND RESULTS: Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow-up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow-up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable-adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow-up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. CONCLUSIONS: Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with bet-ter RV systolic function. Higher baseline BMI and greater age-related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.

KW - Body mass index

KW - Fitness

KW - Pulmonary artery systolic pressure

KW - Right ventricular function

UR - http://www.scopus.com/inward/record.url?scp=85104047385&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85104047385&partnerID=8YFLogxK

U2 - 10.1161/JAHA.120.016968

DO - 10.1161/JAHA.120.016968

M3 - Article

C2 - 33775106

AN - SCOPUS:85104047385

SN - 2047-9980

VL - 10

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 7

M1 - e016968

ER -

Longitudinal associations of fitness and obesity in young adulthood with right ventricular function and pulmonary artery systolic pressure in middle age: The cardia study

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this