Heart structure changes in midlife linked to long-term disease risk

Higher left atrial end-systolic dimension (LASD), an increased measurement of the left upper chamber of the heart, and left ventricular mass (LVM), a clinical measurement of the weight of the heart's left ventricular myocardium, are well-established indicators of cardiovascular damage that are associated with a higher risk of cardiovascular disease (CVD) in the short-term (less than 10 years). However, there is limited evidence regarding similar long-term associations.

A new study by researchers from Boston University Chobanian & Avedisian School of Medicine has reported that higher values of LASD and LVM during midlife are both associated with a higher risk of adverse health outcomes later in life, including mortality, CVD, dementia, hypertension, diabetes, and chronic kidney disease. These findings underscore the importance of maintaining optimal LASD and LVM values over the course of a lifetime.

It is important to make appropriate lifestyle changes and follow heart-healthy habits, such as eating healthy, exercise regularly, maintaining a healthy body mass index, limiting alcohol intake, and avoid smoking; these choices will contribute to maintaining optimal values of LVM and LASD, which subsequently may lower the risk of CVD and other adverse outcomes."

Vanessa Xanthakis, PhD, corresponding author, associate professor of medicine and investigator of the Framingham Heart Study (FHS)

Using data from the FHS, one of the longest-running epidemiological studies in the world, the researchers analyzed 8,192 participants (mean age 48 ± 13 years, 54% women). These participants attended routine echocardiography (ultrasound of the heart) during their visits. Participants also contributed their data on multiple lifestyle factors, anthropometric measures, and other variables such as blood pressure, use of hypertensive medications, total to high-density lipoprotein ratio, diabetes mellitus, fasting blood glucose, and other risk factors using standardized protocols and assays.

According to the researchers, most studies evaluating relations between echocardiographic measurements and risk of disease are limited to shorter follow-up times but thanks to the richness of the FHS data, Xanthakis et al. were able to follow participants for approximately 30 years.

"The number of people with CVD and related comorbidities is constantly increasing, so we are hoping that our study will empower people to commit to healthier lifestyles to mitigate their risk for disease and contribute to an overall healthy population," adds Xanthakis.

These findings appear online in the Journal of the American College of Cardiology-Advances.

This work was supported by contracts NO1-HC-25195, HHSN268201500001I, and 75N92019D00031 from the National Heart, Lung, and Blood Institute.