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

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.840790

DOI=10.3389/fcvm.2022.840790

ISSN=2297-055X

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 magnetic resonance imaging (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; male, 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 standard deviation (SD) = 5.3 kg/m2) was associated with increased left ventricular (LV) mass (+7.3g), biventricular higher end-diastolic (LV, +8.6ml) and stroke volumes (+5.0ml), higher native T1 (+7.3ms) and lower extracellular volume (ECV, -0.38%), whereas 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 (+6.9g), higher LV ejection fraction (+1.0%) and lower ECV (-0.48%), whereas increased diastolic blood pressure was associated with lower LV ejection fraction. In T2D, increased HbA1c (per SD=9.0 mmol/mol) was associated with increased LV mass (+2.2g), higher RV end-diastolic volume (+3.2ml) 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.