Association of Aortic Root Dilation from Early Adulthood to Middle Age with Cardiac Structure and Function: The CARDIA Study

Abstract

BACKGROUND The human aorta dilates with advancing age. However, the association between progressive aortic dilation with aging and cardiac remodeling has not been established in studies of community-dwelling adults. We hypothesized that there would be a relationship between aortic size increase over the early adult lifespan with left ventricular (LV) structural remodeling and subclinical LV dysfunction in middle age, even in the absence of overt cardiovascular and valvular disease. METHODS Included were Coronary Artery Risk Development in Young Adults (CARDIA) study participants (n=2933) aged 23–35 years with available transthoracic echocardiography measurements during 20-years of follow-up. Multivariable linear regression models assessed sex-specific associations between 20-year change in aortic root diameter with LV structure and function. RESULTS Larger aortic root diameter at 20-year follow-up was associated with greater LV mass (2.77g/mm versus 2.18/mm, in men and women respectively, p<0.001). In longitudinal analyses, increase in aortic root diameter over 20-year follow up was associated with a greater 20-year increase in LV mass and LV Mass to LV end diastolic volume ratio in both sexes. In women but not in men, increased aortic root diameter over 20-years was associated with increased left atrial dimension, impaired E/E′ and impaired early diastolic longitudinal and circumferential strain rates assessed by speckle tracking echocardiography. CONCLUSIONS Progressive increase in aortic root diameter from early adulthood to middle age was associated with increased LV mass and LV concentric remodeling in both sexes and impaired diastolic function predominantly in women.

Epigenetic status of subtelomere of peripheral leukocytes corresponds to cardiographic parameters with a sex association

“…Generally, cardiac hypertrophy with diastolic dysfunction and enlarged diameter of the aorta are regarded as aging‐associated cardiovascular structural changes. Among these, aorta narrowing does not coincide with previous reports . This discrepancy might be derived from a population bias, as the size of the population analyzed was not large.…”

“…This sex association might be caused by sex hormone differences. Estrogen has been reported to promote the expression of telomerase, which protects aged somatic cells from entering a cell senescence stage in premenopausal women . Even after menopause, aging‐associated telomeric attrition is accelerated with a decline of estrogen levels.…”

“…Among these, aorta narrowing does not coincide with previous reports. 19,20 This discrepancy might be derived from a population bias, as the size of the population analyzed was not large. Racial bias is also possible, as the study population was limited to Japanese individuals.…”

“…Estrogen has been reported to promote the expression of telomerase, which protects aged somatic cells from entering a cell senescence stage in premenopausal women. 19,21,22 Even after menopause, aging-associated telomeric attrition is accelerated with a decline of estrogen levels. In this process, aged somatic cells accumulate, leading to agingassociated change of the cardiographic variables.…”

Coffee and tea consumption in the early adult lifespan and left ventricular function in middle age: the CARDIA study

“…Experienced sonographers using a standardized protocol across all field sites, performed an echocardiographic Coffee and tea consumption in the early adult lifespan and left ventricular function in middle age: the CARDIA study evaluation using an Artida cardiac ultrasound machine (Toshiba Medical Systems, Otawara, Japan). 12 Quality control and image analysis were performed at an echocardiography-reading centre (Johns Hopkins University, Baltimore, Maryland). Traditional and tissue Doppler measurements were made from digitized images using a standard offline image analysis software system (Digisonics, Inc., Houston, Texas).…”