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. 2017 Oct 3;12(10):e0185114.
doi: 10.1371/journal.pone.0185114. eCollection 2017.

The impact of cardiovascular risk factors on cardiac structure and function: Insights from the UK Biobank imaging enhancement study

Steffen E Petersen  1 , Mihir M Sanghvi  1 , Nay Aung  1 , Jackie A Cooper  1 , José Miguel Paiva  1 , Filip Zemrak  1 , Kenneth Fung  1 , Elena Lukaschuk  2 , Aaron M Lee  1 , Valentina Carapella  2 , Young Jin Kim  2   3 , Stefan K Piechnik  2 , Stefan Neubauer  2
Affiliations

The impact of cardiovascular risk factors on cardiac structure and function: Insights from the UK Biobank imaging enhancement study

Steffen E Petersen et al. PLoS One. .

Abstract

Aims: The UK Biobank is a large-scale population-based study utilising cardiovascular magnetic resonance (CMR) to generate measurements of atrial and ventricular structure and function. This study aimed to quantify the association between modifiable cardiovascular risk factors and cardiac morphology and function in individuals without known cardiovascular disease.

Methods: Age, sex, ethnicity (non-modifiable) and systolic blood pressure, diastolic blood pressure, smoking status, exercise, body mass index (BMI), high cholesterol, diabetes, alcohol intake (modifiable) were considered important cardiovascular risk factors. Multivariable regression models were built to ascertain the association of risk factors on left ventricular (LV), right ventricular (RV), left atrial (LA) and right atrial (RA) CMR parameters.

Results: 4,651 participants were included in the analysis. All modifiable risk factors had significant effects on differing atrial and ventricular parameters. BMI was the modifiable risk factor most consistently associated with subclinical changes to CMR parameters, particularly in relation to higher LV mass (+8.3% per SD [4.3 kg/m2], 95% CI: 7.6 to 8.9%), LV (EDV: +4.8% per SD, 95% CI: 4.2 to 5.4%); ESV: +4.4% per SD, 95% CI: 3.5 to 5.3%), RV (EDV: +5.3% per SD, 95% CI: 4.7 to 5.9%; ESV: +5.4% per SD, 95% CI: 4.5 to 6.4%) and LA maximal (+8.6% per SD, 95% CI: 7.4 to 9.7%) volumes. Increases in SBP were associated with higher LV mass (+6.8% per SD, 95% CI: 5.9 to 7.7%), LV (EDV: +4.5% per SD, 95% CI: 3.6 to 5.4%; ESV: +2.0% per SD, 95% CI: 0.8 to 3.3%) volumes. The presence of diabetes or high cholesterol resulted in smaller volumes and lower ejection fractions.

Conclusions: Modifiable risk factors are associated with subclinical alterations in structure and function in all four cardiac chambers. BMI and systolic blood pressure are the most important modifiable risk factors affecting CMR parameters known to be linked to adverse outcomes.

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Conflict of interest statement

Competing Interests: Professor Steffen Petersen provides consultancy to Circle Cardiovascular Imaging Inc., Calgary, Canada. The other authors declare that they have no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Modifiable risk factors and contribution to adjusted R2 as a percentage.
Body mass index, systolic and diastolic blood pressure are the modifiable risk factors which most consistently contribute to alterations in cardiac structure and function.
See this image and copyright information in PMC

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