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

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Article numbere016968
JournalJournal of the American Heart Association
Volume10
Issue number7
DOIs
StatePublished - Apr 6 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).

Funding Information:
Dr Pandey has served on the advisory board of Roche Diagnostics and has received research support from the Gilead Sciences Research Scholar Program and Applied Therapeutics. The remaining authors have no disclosures to report.

Publisher Copyright:
© 2021 The Authors.

Keywords

  • Body mass index
  • Fitness
  • Pulmonary artery systolic pressure
  • Right ventricular function

PubMed: MeSH publication types

  • Journal Article

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