Cardiovascular Function in Multi-Ethnic Study of Atherosclerosis: Normal Values by Age, Sex, and Ethnicity

Natori, Shunsuke; Lai, Shenghan; Finn, J. Paul; Gomes, Antoinette S.; Hundley, W. Gregory; Jerosch‐Herold, Michael; Pearson, Gregory; Sinha, Shantanu; Arai, Andrew E.; Lima, João A.C.; Bluemke, David A.

doi:10.2214/ajr.04.1868

Cited by 414 publications

(412 citation statements)

References 33 publications

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“…This is consistent with the sex associated difference in LV mass reported in the ASE guidelines (21% on average for linear dimensions) as well as by large population based studies such as The Multi-Ethnic Study of Atherosclerosis (21%), the Asklepios Study (21%) or the general population study of Devereux et al (22%). 13,21,22 This consistent percentage suggests that if a population based study finds a significantly greater than 20% difference in LV mass indexed to BSA between sexes, one has to question whether a body size composition bias may have been introduced. Consistent with our finding, a recent study by Pressler et al also observed no sex M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 8 related differences in LV mass indexed to LBM in athletes participating in low to moderate intensity sports.…”

Section: Discussionmentioning

confidence: 97%

“…Consistent with previous studies, we have also found that female have a lower mass to volume ratio suggesting more eccentric remodeling. 21 This however assumes that mass and volume should be scaled using the same allometric indexing. If we use the different allometric coefficient for volume found in our study and the study of George et al, the sex differences in remodeling pattern disappears or reverse between sexes.…”

Section: Discussionmentioning

confidence: 99%

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Gender Differences in Ventricular Remodeling and Function in College Athletes, Insights from Lean Body Mass Scaling and Deformation Imaging

Giraldeau

Kobayashi

Finocchiaro

et al. 2015

The American Journal of Cardiology

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Several studies suggest sex-differences in ventricular dimensions in athletes. Few studies have, however, made comparisons of data indexed for lean body mass (LBM) using allometry. Ninety Caucasian college athletes (mixed-sports) who were matched for age, ethnicity and sport total cardiovascular demands, underwent Dual Energy X-Ray Absorptiometry (DEXA) scan for quantification of LBM. Athletes underwent comprehensive assessment of left and right ventricular and atrial structure and function using 2D echocardiography as well as deformation imaging using the TOMTEC analysis system. The mean age of the study population was 18.9±1.9 years. Female athletes (n=45) had a higher fat free percentage (19.4±3.7%) compared to male athletes (11.5±3.7%). When scaled to body surface area (BSA), male had on average 19±3% (P< 0.001) higher LV mass; in contrast when scaled to LBM there was no significant difference in indexed LV mass -1.4 ± 3.0% (P=0.63). Similarly, when allometrically scaled to LBM, there was no significant sex-based difference in LV or left atrial volumes. Although female athletes had mildly higher LV ejection fraction (EF) and LV global longitudinal strain in absolute value, systolic strain rate and allometrically indexed stroke volume (SV) were not different between sexes (1.5±3.6% (P=0.63) and 0.0±3.7% (P=0.93) respectively). There were no differences in any of the functional atrial indices including strain or strain rate parameters. In conclusion, sex related differences in ventricular dimensions or function (stroke volume) appear less marked, if not absent, when indexing using LBM allometrically.Key words: Athletics, Ventricular Remodeling and Function, Atrial remodeling, Lean body mass, Deformation imaging, echocardiographyDespite several years of investigation, the extent of sex differences in ventricular dimension and function in athletes remains a subject of debate. [1][2][3][4][5][6][7][8][9][10][11] Part of the controversy may be related to the fact that only few studies took into account body composition when scaling cardiac dimensions. In this study, we sought to determine, in college athletes, whether sex-related differences in ventricular dimensions persisted after adjustment for lean body mass (LBM). In second intention, we sought to compare sex associated differences in functional parameters including ventricular and atrial strain analysis. MethodsIn 2008, 315 Caucasian college athletes were included in the pre-season cardiac screening process at Stanford University using the AHA-12 point questionnaire, ECG and a screening echocardiogram. Of these participants, 124 volunteered to undergo Dual Energy X-Ray Absorptiometry (DEXA) for assessment of body composition. Of these subjects, we selected 90 (45 male, 45females) were matched according to age, ethnicity/race and total cardiovascular demand. 12 We excluded subjects who participated in sports in high dynamic and static component such as rowing, cycling and triathlon as these were asymmetrically distributed among sexes. 12 The sports di...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Gender Differences in Ventricular Remodeling and Function in College Athletes, Insights from Lean Body Mass Scaling and Deformation Imaging

Giraldeau

Kobayashi

Finocchiaro

et al. 2015

The American Journal of Cardiology

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“…Cardiac magnetic resonance imaging was performed at the baseline visit using scanners with 1.5‐T magnets, a 4‐element, phased‐array surface coil placed anteriorly and posteriorly, ECG gating, and brachial artery blood pressure (BP) monitoring 30. All images were read centrally and left ventricular mass determined as previously described 30, 38…”

Section: Methodsmentioning

confidence: 99%

Association Between APOL1 Genotypes and Risk of Cardiovascular Disease in MESA (Multi‐Ethnic Study of Atherosclerosis)

Chen

Katz

Estrella

et al. 2017

JAHA

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Background APOL1 genetic variants confer an increased risk for kidney disease. Their associations with cardiovascular disease (CVD) are less certain. We aimed to compare the prevalence of subclinical CVD and incidence of atherosclerotic CVD and heart failure by APOL1 genotypes among self‐identified black participants of MESA (Multi‐Ethnic Study of Atherosclerosis).Methods and ResultsCross‐sectional associations of APOL1 genotypes (high‐risk=2 alleles; low‐risk=0 or 1 allele) with coronary artery calcification, carotid‐intimal media thickness, and left ventricular mass were evaluated using logistic and linear regression. Longitudinal associations of APOL1 genotypes with incident myocardial infarction, stroke, coronary heart disease, and congestive heart failure were examined using Cox regression. We adjusted for African ancestry, age, and sex. We also evaluated whether hypertension or kidney function markers explained the observed associations. Among 1746 participants with APOL1 genotyping (mean age 62 years, 55% women, mean cystatin C–based estimated glomerular filtration rate 89 mL/min per 1.73 m2, 12% with albuminuria), 12% had the high‐risk genotypes. We found no difference in prevalence or severity of coronary artery calcification, carotid‐intimal media thickness, or left ventricular mass by APOL1 genotypes. The APOL1 high‐risk group was 82% more likely to develop incident heart failure compared with the low‐risk group (95% confidence interval, 1.01–3.28). Adjusting for hypertension (hazard ratio, 1.80; 95% confidence interval, 1.00–3.24) but not markers of kidney function (hazard ratio, 1.86; 95% confidence interval, 1.03–3.35) slightly attenuated this association. The APOL1 high‐risk genotypes were not significantly associated with other clinical CVD outcomes.ConclusionsAmong blacks without baseline CVD, the APOL1 high‐risk variants may be associated with increased risk for incident heart failure but not subclinical CVD or incident clinical atherosclerotic CVD.

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“…Comparisons between ethnicities may require larger sample sizes, with samples of less than 10 participants needed for LV mass/BSA, septal wall thickness and LV posterior wall thickness among one study [28]. A priori sample size calculations based on another investigation suggest that ethnic differences may be identified with as few as 8 participants per ethnic group for LV mass, and as few as 22–23 participants per ethnic group for stroke volume and LV mass/BSA [12]. …”

Section: Methodsmentioning

confidence: 99%

Cardiovascular dynamics of Canadian Indigenous peoples

Foulds

Bredin

2018

International Journal of Circumpolar Health

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Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min−1∙L−1 vs. 15.36 ± 2.97 mmHg∙min−1∙L−1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL−1·m−2 vs. 0.55 ± 0.17 mmHg·mL−1·m−2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min−1∙L−1 vs. 13.93 ± 2.61 mmHg∙min−1∙L−1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

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Cardiovascular Function in Multi-Ethnic Study of Atherosclerosis: Normal Values by Age, Sex, and Ethnicity

Cited by 414 publications

References 33 publications

Gender Differences in Ventricular Remodeling and Function in College Athletes, Insights from Lean Body Mass Scaling and Deformation Imaging

Gender Differences in Ventricular Remodeling and Function in College Athletes, Insights from Lean Body Mass Scaling and Deformation Imaging

Association Between APOL1 Genotypes and Risk of Cardiovascular Disease in MESA (Multi‐Ethnic Study of Atherosclerosis)

Cardiovascular dynamics of Canadian Indigenous peoples

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