Cardiac Alterations on 3T MRI in Young Adults With Sedentary Lifestyle-Related Risk Factors

Gert J H Snel; Maaike van den Boomen; Katia Hurtado-Ortiz; Riemer H J A Slart; Vincent M van Deursen; Christopher T Nguyen; David E Sosnovik; Rudi A J O Dierckx; Birgitta K Velthuis; Ronald J H Borra; Niek H J Prakken

doi:10.3389/fcvm.2022.840790

Cardiac Alterations on 3T MRI in Young Adults With Sedentary Lifestyle-Related Risk Factors

Front Cardiovasc Med. 2022 Feb 22:9:840790. doi: 10.3389/fcvm.2022.840790. eCollection 2022.

Authors

Gert J H Snel¹, Maaike van den Boomen^{1

2

3}, Katia Hurtado-Ortiz⁴, Riemer H J A Slart^{5

6}, Vincent M van Deursen⁷, Christopher T Nguyen^{2

3}, David E Sosnovik^{2

3

8}, Rudi A J O Dierckx⁵, Birgitta K Velthuis⁹, Ronald J H Borra^{1

5}, Niek H J Prakken¹

Affiliations

¹ Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
² Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
³ Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
⁴ Faculty of Medicine, National Autonomous University of Mexico (UNAM), Ciudad Universitaria, Mexico City, Mexico.
⁵ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
⁶ Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, Netherlands.
⁷ Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
⁸ Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, United States.
⁹ Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands.

Abstract

Background: Young adult populations with the sedentary lifestyle-related risk factors overweight, hypertension, and type 2 diabetes (T2D) are growing, and associated cardiac alterations could overlap early findings in non-ischemic cardiomyopathy on cardiovascular MRI. We aimed to investigate cardiac morphology, function, and tissue characteristics for these cardiovascular risk factors.

Methods: Non-athletic non-smoking asymptomatic adults aged 18-45 years were prospectively recruited and underwent 3Tesla cardiac MRI. Multivariate linear regression was performed to investigate independent associations of risk factor-related parameters with cardiac MRI values.

Results: We included 311 adults (age, 32 ± 7 years; men, 49%). Of them, 220 subjects had one or multiple risk factors, while 91 subjects were free of risk factors. For overweight, increased body mass index (per SD = 5.3 kg/m²) was associated with increased left ventricular (LV) mass (+7.3 g), biventricular higher end-diastolic (LV, +8.6 ml), and stroke volumes (SV; +5.0 ml), higher native T₁ (+7.3 ms), and lower extracellular volume (ECV, -0.38%), whereas the higher waist-hip ratio was associated with lower biventricular volumes. Regarding hypertension, increased systolic blood pressure (per SD = 14 mmHg) was associated with increased LV mass (+6.9 g), higher LV ejection fraction (EF; +1.0%), and lower ECV (-0.48%), whereas increased diastolic blood pressure was associated with lower LV EF. In T2D, increased HbA1c (per SD = 9.0 mmol/mol) was associated with increased LV mass (+2.2 g), higher right ventricular end-diastolic volume (+3.2 ml), and higher ECV (+0.27%). Increased heart rate was linked with decreased LV mass, lower biventricular volumes, and lower T₂ values.

Conclusions: Young asymptomatic adults with overweight, hypertension, and T2D show subclinical alterations in cardiac morphology, function, and tissue characteristics. These alterations should be considered in cardiac MRI-based clinical decision making.

Keywords: cardiac function; cardiovascular magnetic resonance imaging; hypertension; myocardial tissue characterization; overweight; type 2 diabetes; young adults.

Grants and funding

R01 HL151704/HL/NHLBI NIH HHS/United States