Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study
Objective: To generate data-driven phenogroups of cardiac structure and function based on echocardiographic measures assessed in asymptomatic middle-aged adults free of CVD, and examine associations between these newly defined phenogroups and incident premature cardiovascular disease (CVD). Methods:...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667724002575 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846128213356445696 |
|---|---|
| author | Michael C. Wang Toluwalase Awoyemi Norrina B. Allen Ravi Shah Matthew Nayor Yuan Luo Joao A.C. Lima Donald M. Lloyd-Jones Sadiya S. Khan |
| author_facet | Michael C. Wang Toluwalase Awoyemi Norrina B. Allen Ravi Shah Matthew Nayor Yuan Luo Joao A.C. Lima Donald M. Lloyd-Jones Sadiya S. Khan |
| author_sort | Michael C. Wang |
| collection | DOAJ |
| description | Objective: To generate data-driven phenogroups of cardiac structure and function based on echocardiographic measures assessed in asymptomatic middle-aged adults free of CVD, and examine associations between these newly defined phenogroups and incident premature cardiovascular disease (CVD). Methods: Data were analyzed from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study free of CVD who underwent an echocardiogram at the Year 25 (2010-2011) in-person examination. Continuous echocardiographic measures of left heart structure, left ventricular systolic function (including strain) and diastolic function, right ventricular systolic function, and hemodynamic measures were included in latent class analysis to generate novel phenogroups. Associations between data-driven phenogroups and risk of premature CVD (coronary artery disease, stroke, or heart failure) were estimated using Cox proportional hazards regression adjusted for traditional CVD risk factors. Results: Among 3361 participants, mean (standard deviation) age was 50.1 (3.6) years, 57% were female, and 46% were non-Hispanic Black. Three overall phenogroups were identified and labeled as: (1) optimal cardiac mechanics (36.2%); (2) suboptimal systolic function (38.2%); and (3) suboptimal diastolic function (25.6%). Over a median 8.9 years of follow-up, 121 premature CVD events occurred. Risk of CVD was higher in the suboptimal diastolic function group (unadjusted hazard ratio [HR] 4.08 [95% CI: 2.48, 6.71] and adjusted HR 1.95 [1.12, 3.40]) compared with the optimal group. The suboptimal systolic function group had a higher unadjusted risk of CVD (1.86 [1.10, 3.15]), which was attenuated after adjustment for CVD risk factors (1.36 [0.79, 2.36]). Conclusions and relevance: Unbiased, data-driven clustering of echocardiographic measures in middle-aged adults identified distinct patterns of cardiac remodeling that were associated with risk of premature CVD. Premature CVD risk was highest with the pattern of suboptimal diastolic function. This suggests potential utility of a composite echocardiography-based index for prioritizing prevention strategies earlier in the life course. |
| format | Article |
| id | doaj-art-e77d1a2043ef4b6a9c0ef46d2fa42aeb |
| institution | Kabale University |
| issn | 2666-6677 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-e77d1a2043ef4b6a9c0ef46d2fa42aeb2024-12-11T05:57:46ZengElsevierAmerican Journal of Preventive Cardiology2666-66772024-12-0120100889Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) studyMichael C. Wang0Toluwalase Awoyemi1Norrina B. Allen2Ravi Shah3Matthew Nayor4Yuan Luo5Joao A.C. Lima6Donald M. Lloyd-Jones7Sadiya S. Khan8Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, United StatesDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United StatesDivision of Cardiology, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Cardiology, Boston University School of Medicine, Boston, MA, United StatesDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United StatesDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United StatesDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Corresponding author at: Division of Cardiology, Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive Ste, 1400, Chicago, IL 60611, United States.Objective: To generate data-driven phenogroups of cardiac structure and function based on echocardiographic measures assessed in asymptomatic middle-aged adults free of CVD, and examine associations between these newly defined phenogroups and incident premature cardiovascular disease (CVD). Methods: Data were analyzed from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study free of CVD who underwent an echocardiogram at the Year 25 (2010-2011) in-person examination. Continuous echocardiographic measures of left heart structure, left ventricular systolic function (including strain) and diastolic function, right ventricular systolic function, and hemodynamic measures were included in latent class analysis to generate novel phenogroups. Associations between data-driven phenogroups and risk of premature CVD (coronary artery disease, stroke, or heart failure) were estimated using Cox proportional hazards regression adjusted for traditional CVD risk factors. Results: Among 3361 participants, mean (standard deviation) age was 50.1 (3.6) years, 57% were female, and 46% were non-Hispanic Black. Three overall phenogroups were identified and labeled as: (1) optimal cardiac mechanics (36.2%); (2) suboptimal systolic function (38.2%); and (3) suboptimal diastolic function (25.6%). Over a median 8.9 years of follow-up, 121 premature CVD events occurred. Risk of CVD was higher in the suboptimal diastolic function group (unadjusted hazard ratio [HR] 4.08 [95% CI: 2.48, 6.71] and adjusted HR 1.95 [1.12, 3.40]) compared with the optimal group. The suboptimal systolic function group had a higher unadjusted risk of CVD (1.86 [1.10, 3.15]), which was attenuated after adjustment for CVD risk factors (1.36 [0.79, 2.36]). Conclusions and relevance: Unbiased, data-driven clustering of echocardiographic measures in middle-aged adults identified distinct patterns of cardiac remodeling that were associated with risk of premature CVD. Premature CVD risk was highest with the pattern of suboptimal diastolic function. This suggests potential utility of a composite echocardiography-based index for prioritizing prevention strategies earlier in the life course.http://www.sciencedirect.com/science/article/pii/S2666667724002575EchocardiogramLatent class analysisPhenogroupCardiovascular disease |
| spellingShingle | Michael C. Wang Toluwalase Awoyemi Norrina B. Allen Ravi Shah Matthew Nayor Yuan Luo Joao A.C. Lima Donald M. Lloyd-Jones Sadiya S. Khan Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study American Journal of Preventive Cardiology Echocardiogram Latent class analysis Phenogroup Cardiovascular disease |
| title | Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study |
| title_full | Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study |
| title_fullStr | Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study |
| title_full_unstemmed | Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study |
| title_short | Latent class analysis of cardiac structure and function and association with premature cardiovascular disease: The Coronary Artery Risk Development in Young Adults (CARDIA) study |
| title_sort | latent class analysis of cardiac structure and function and association with premature cardiovascular disease the coronary artery risk development in young adults cardia study |
| topic | Echocardiogram Latent class analysis Phenogroup Cardiovascular disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666667724002575 |
| work_keys_str_mv | AT michaelcwang latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT toluwalaseawoyemi latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT norrinaballen latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT ravishah latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT matthewnayor latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT yuanluo latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT joaoaclima latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT donaldmlloydjones latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy AT sadiyaskhan latentclassanalysisofcardiacstructureandfunctionandassociationwithprematurecardiovasculardiseasethecoronaryarteryriskdevelopmentinyoungadultscardiastudy |