Pulmonary Artery Acceleration Time in Young Adulthood and Cardiovascular Outcomes Later in Life: The Coronary Artery Risk Development in Young Adults Study

Henrique T. Moreira, Henrique D. Vasconcellos, Bharath Ambale-Venkatesh, Evan L. Brittain, Chike C. Nwabuo, André Schmidt, Donald M. Lloyd-Jones, John J. Carr, Cora E. Lewis, David R. Jacobs, Samuel S. Gidding, João A.C. Lima

Research output: Contribution to journalArticle

Abstract

Background: Lower pulmonary artery acceleration time (PAcT) is correlated with higher pulmonary artery pressure. The aim of this study was to test the hypothesis that PAcT measured in young adulthood would be associated with future cardiovascular outcomes. Methods: In the Coronary Artery Risk Development in Young Adults year 5 examination (1990–1991), PAcT was measured as the time interval from onset to peak flow velocity at the pulmonary valve annulus on Doppler echocardiography. The primary outcome was a composite of fatal or nonfatal cardiovascular disease events: myocardial infarction, non–myocardial infarction acute coronary syndrome, coronary revascularization, congestive heart failure, stroke, transient ischemic attack, carotid artery disease, and peripheral arterial disease. Results: PAcT was obtained in 4,171 participants (mean age, 30 ± 4 years, 55% women, 51% white). PAcT groups obtained using linear spline methodology were as follows: group I, PAcT ≥ 196 msec (n = 122); group II, PAcT < 196 and ≥115 msec (n = 3,195); and group III, PAcT < 115 msec (n = 854). During follow-up (median, 24.9 years), the primary outcome occurred in 216 participants (5.2%); 66 of 854 (7.7%) of those with PAcT < 115 msec, 149 of 3,195 (4.7%) of those with intermediate PAcT level, and one of 122 (0.8%) of those with PAcT ≥ 196 msec. In a fully adjusted model, the lowest and intermediate PAcT groups had hazard ratios of 8.3 (95% CI, 1.1–62.1; P =.04) and 6.8 (95% CI, 0.9–50.5; P =.06), respectively, in comparison with the highest PAcT group. Conclusions: PAcT is useful for better identifying young adults at higher risk for cardiovascular events, who may benefit from a strict control of modifiable cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)82-89.e1
JournalJournal of the American Society of Echocardiography
Volume33
Issue number1
DOIs
StatePublished - Jan 2020

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Pulmonary Artery
Young Adult
Coronary Vessels
Pulmonary Valve
Carotid Artery Diseases
Doppler Echocardiography
Peripheral Arterial Disease
Transient Ischemic Attack
Acute Coronary Syndrome
Infarction
Cardiovascular Diseases
Heart Failure
Stroke
Myocardial Infarction

Keywords

  • Cardiovascular diseases
  • Echocardiography
  • Pulmonary artery

PubMed: MeSH publication types

  • Journal Article

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Pulmonary Artery Acceleration Time in Young Adulthood and Cardiovascular Outcomes Later in Life : The Coronary Artery Risk Development in Young Adults Study. / Moreira, Henrique T.; Vasconcellos, Henrique D.; Ambale-Venkatesh, Bharath; Brittain, Evan L.; Nwabuo, Chike C.; Schmidt, André; Lloyd-Jones, Donald M.; Carr, John J.; Lewis, Cora E.; Jacobs, David R.; Gidding, Samuel S.; Lima, João A.C.

In: Journal of the American Society of Echocardiography, Vol. 33, No. 1, 01.2020, p. 82-89.e1.

Research output: Contribution to journalArticle

Moreira, HT, Vasconcellos, HD, Ambale-Venkatesh, B, Brittain, EL, Nwabuo, CC, Schmidt, A, Lloyd-Jones, DM, Carr, JJ, Lewis, CE, Jacobs, DR, Gidding, SS & Lima, JAC 2020, 'Pulmonary Artery Acceleration Time in Young Adulthood and Cardiovascular Outcomes Later in Life: The Coronary Artery Risk Development in Young Adults Study', Journal of the American Society of Echocardiography, vol. 33, no. 1, pp. 82-89.e1. https://doi.org/10.1016/j.echo.2019.07.025
Moreira, Henrique T. ; Vasconcellos, Henrique D. ; Ambale-Venkatesh, Bharath ; Brittain, Evan L. ; Nwabuo, Chike C. ; Schmidt, André ; Lloyd-Jones, Donald M. ; Carr, John J. ; Lewis, Cora E. ; Jacobs, David R. ; Gidding, Samuel S. ; Lima, João A.C. / Pulmonary Artery Acceleration Time in Young Adulthood and Cardiovascular Outcomes Later in Life : The Coronary Artery Risk Development in Young Adults Study. In: Journal of the American Society of Echocardiography. 2020 ; Vol. 33, No. 1. pp. 82-89.e1.
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abstract = "Background: Lower pulmonary artery acceleration time (PAcT) is correlated with higher pulmonary artery pressure. The aim of this study was to test the hypothesis that PAcT measured in young adulthood would be associated with future cardiovascular outcomes. Methods: In the Coronary Artery Risk Development in Young Adults year 5 examination (1990–1991), PAcT was measured as the time interval from onset to peak flow velocity at the pulmonary valve annulus on Doppler echocardiography. The primary outcome was a composite of fatal or nonfatal cardiovascular disease events: myocardial infarction, non–myocardial infarction acute coronary syndrome, coronary revascularization, congestive heart failure, stroke, transient ischemic attack, carotid artery disease, and peripheral arterial disease. Results: PAcT was obtained in 4,171 participants (mean age, 30 ± 4 years, 55{\%} women, 51{\%} white). PAcT groups obtained using linear spline methodology were as follows: group I, PAcT ≥ 196 msec (n = 122); group II, PAcT < 196 and ≥115 msec (n = 3,195); and group III, PAcT < 115 msec (n = 854). During follow-up (median, 24.9 years), the primary outcome occurred in 216 participants (5.2{\%}); 66 of 854 (7.7{\%}) of those with PAcT < 115 msec, 149 of 3,195 (4.7{\%}) of those with intermediate PAcT level, and one of 122 (0.8{\%}) of those with PAcT ≥ 196 msec. In a fully adjusted model, the lowest and intermediate PAcT groups had hazard ratios of 8.3 (95{\%} CI, 1.1–62.1; P =.04) and 6.8 (95{\%} CI, 0.9–50.5; P =.06), respectively, in comparison with the highest PAcT group. Conclusions: PAcT is useful for better identifying young adults at higher risk for cardiovascular events, who may benefit from a strict control of modifiable cardiovascular risk factors.",
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T2 - The Coronary Artery Risk Development in Young Adults Study

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AU - Vasconcellos, Henrique D.

AU - Ambale-Venkatesh, Bharath

AU - Brittain, Evan L.

AU - Nwabuo, Chike C.

AU - Schmidt, André

AU - Lloyd-Jones, Donald M.

AU - Carr, John J.

AU - Lewis, Cora E.

AU - Jacobs, David R.

AU - Gidding, Samuel S.

AU - Lima, João A.C.

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N2 - Background: Lower pulmonary artery acceleration time (PAcT) is correlated with higher pulmonary artery pressure. The aim of this study was to test the hypothesis that PAcT measured in young adulthood would be associated with future cardiovascular outcomes. Methods: In the Coronary Artery Risk Development in Young Adults year 5 examination (1990–1991), PAcT was measured as the time interval from onset to peak flow velocity at the pulmonary valve annulus on Doppler echocardiography. The primary outcome was a composite of fatal or nonfatal cardiovascular disease events: myocardial infarction, non–myocardial infarction acute coronary syndrome, coronary revascularization, congestive heart failure, stroke, transient ischemic attack, carotid artery disease, and peripheral arterial disease. Results: PAcT was obtained in 4,171 participants (mean age, 30 ± 4 years, 55% women, 51% white). PAcT groups obtained using linear spline methodology were as follows: group I, PAcT ≥ 196 msec (n = 122); group II, PAcT < 196 and ≥115 msec (n = 3,195); and group III, PAcT < 115 msec (n = 854). During follow-up (median, 24.9 years), the primary outcome occurred in 216 participants (5.2%); 66 of 854 (7.7%) of those with PAcT < 115 msec, 149 of 3,195 (4.7%) of those with intermediate PAcT level, and one of 122 (0.8%) of those with PAcT ≥ 196 msec. In a fully adjusted model, the lowest and intermediate PAcT groups had hazard ratios of 8.3 (95% CI, 1.1–62.1; P =.04) and 6.8 (95% CI, 0.9–50.5; P =.06), respectively, in comparison with the highest PAcT group. Conclusions: PAcT is useful for better identifying young adults at higher risk for cardiovascular events, who may benefit from a strict control of modifiable cardiovascular risk factors.

AB - Background: Lower pulmonary artery acceleration time (PAcT) is correlated with higher pulmonary artery pressure. The aim of this study was to test the hypothesis that PAcT measured in young adulthood would be associated with future cardiovascular outcomes. Methods: In the Coronary Artery Risk Development in Young Adults year 5 examination (1990–1991), PAcT was measured as the time interval from onset to peak flow velocity at the pulmonary valve annulus on Doppler echocardiography. The primary outcome was a composite of fatal or nonfatal cardiovascular disease events: myocardial infarction, non–myocardial infarction acute coronary syndrome, coronary revascularization, congestive heart failure, stroke, transient ischemic attack, carotid artery disease, and peripheral arterial disease. Results: PAcT was obtained in 4,171 participants (mean age, 30 ± 4 years, 55% women, 51% white). PAcT groups obtained using linear spline methodology were as follows: group I, PAcT ≥ 196 msec (n = 122); group II, PAcT < 196 and ≥115 msec (n = 3,195); and group III, PAcT < 115 msec (n = 854). During follow-up (median, 24.9 years), the primary outcome occurred in 216 participants (5.2%); 66 of 854 (7.7%) of those with PAcT < 115 msec, 149 of 3,195 (4.7%) of those with intermediate PAcT level, and one of 122 (0.8%) of those with PAcT ≥ 196 msec. In a fully adjusted model, the lowest and intermediate PAcT groups had hazard ratios of 8.3 (95% CI, 1.1–62.1; P =.04) and 6.8 (95% CI, 0.9–50.5; P =.06), respectively, in comparison with the highest PAcT group. Conclusions: PAcT is useful for better identifying young adults at higher risk for cardiovascular events, who may benefit from a strict control of modifiable cardiovascular risk factors.

KW - Cardiovascular diseases

KW - Echocardiography

KW - Pulmonary artery

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