부산대학교 도서관

Background: Longstanding obesity is associated with impaired left ventricle (LV) systolic and diastolic function evaluated by two-dimension echocardiography. Left atrial (LA) remodeling is a prognostic marker for cardiovascular (CV) diseases including heart failure, atrial fibrillation, and stroke. Three-dimensional echocardiography (3DE) allows a more reproducible, and detailed evaluation of cardiac structure and function.Hypotheses: Increases in body mass index (BMI) from early adulthood to middle age will be associated with adverse left atrial (LA) remodeling evaluated by 3DE.Methods: CARDIA is a cohort study that enrolled black and white adults (18-30 years) from 4 US Fields Centers beginning in 1985-1986. Participants who underwent 3DE (Artida Echo System, Toshiba) in the CARDIA Year-30 examination and with BMI measurements during the study follow-up were included in this study (n=1,160). 3DE LA measurements were obtained using a wall motion tracking software (figure). Average percent change in BMI per year over 30 years of follow-up was the main exposure. Multivariable linear regression analyses assessed the relationship between LA structure/ function and average change in BMI, adjusting for demographics and traditional CV risk factors.Results: Median age was 56 (62,58) years, 55% (n=651) women, 45.9% (n=543) African American. As shown in Table 1, after adjusting for demographics and traditional CV risk factors, higher change in BMI was significantly associated with higher LA maximum volume (β= 3.77, p<0.001), higher LA minimum volume (β=1.47, p <0.001), higher LA pre-atrial contraction volume (β=0.07, p<0.001), lower total emptying fraction (β=-0.72, p<0.001)), lower LA passive emptying fraction (β=-0.51, p=0.02), and lower early diastolic strain rate (β=-0.04, p=0.05).Conclusion: Increasing BMI from early adulthood throughout middle age was associated with adverse LA remodeling, reflected by higher LA volumes and lower LA function.