Increasing evidence supports the importance of socioeconomic factors in the development of atherosclerotic cardiovascular disease. However, the association of childhood socioeconomic status (SES) ...with arterial stiffness in adulthood has not been reported. Our aim was to determine whether higher childhood family-level SES is associated with lower arterial stiffness in adulthood. The analyses were performed using data gathered within the longitudinal Young Finns Study. The sample comprised 2566 participants who had data concerning family SES at ages 3 to 18 years in 1980 and arterial pulse wave velocity and carotid artery distensibility measured 21 or 27 years later in adulthood. Higher family SES in childhood was associated with lower arterial stiffness in adulthood; carotid artery distensibility being higher (
value±SE, 0.029±0.0089%/10 mm Hg;
=0.001) and pulse wave velocity lower (
value±SE, -0.062±0.022 m/s;
=0.006) among those with higher family SES in a multivariable analysis adjusted with age, sex, and conventional childhood cardiometabolic risk factors. The association remained significant after further adjustment for participant's SES in adulthood (
value±SE, 0.026±0.010%/10 mm Hg;
=0.01 for carotid artery distensibility and
value±SE, -0.048±0.023 m/s;
=0.04 for pulse wave velocity) but attenuated after adjustment for adulthood cardiometabolic risk factors (
value±SE, 0.015±0.008%/10 mm Hg;
=0.08 for carotid artery distensibility and
value±SE, -0.019±0.02 m/s;
=0.38 for pulse wave velocity). In conclusion, we observed an association between higher family SES in childhood and lower arterial stiffness in adulthood. Our findings suggest that special attention could be paid to children from low SES families to prevent cardiometabolic diseases primordially.
The influence of dietary calcium intake in childhood on adult cardiovascular health is unknown, particularly in those with long-term high intake. To examine both linear and non-linear associations of ...childhood and long-term (between childhood and adulthood) dietary calcium intake with adult cardiovascular risk outcomes.
A population-based prospective cohort study in Finland (n = 1029, aged 3–18 years at baseline). Dietary calcium intake was assessed in childhood (1980, baseline) and adulthood (mean of available data from 2001, 2007 and 2011). Long-term dietary calcium intake was calculated as the mean between childhood and adulthood. Outcomes were measured in 2001, 2007, and/or 2011, and the latest available data were used for analyses, including high carotid intima-media thickness, hypertension, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and triglycerides, arterial pulse wave velocity (PWV), carotid artery compliance (CAC), Young's elastic modulus (YEM), and stiffness index (SI).
There were no significant non-linear or linear associations between childhood or long-term dietary calcium intake with any adult cardiovascular outcomes, after adjustment for age, sex, and childhood and adulthood confounders (e.g., body mass index, systolic blood pressure, smoking, physical activity, fruit and vegetable consumption).
Childhood or long-term dietary calcium intake that is higher than the recommended level is not associated with increased cardiovascular risk in adulthood.
The dynamic shape of the normal adult mitral annulus has been shown to be important to mitral valve function. However, annular dynamics of the healthy mitral valve in children have yet to be ...explored. The aim of this study was to model and quantify the shape and major modes of variation of pediatric mitral valve annuli in four phases of the cardiac cycle using transthoracic echocardiography.
The mitral valve annuli of 100 children and young adults with normal findings on three-dimensional echocardiography were modeled in four different cardiac phases using the SlicerHeart extension for 3D Slicer. Annular metrics were quantified using SlicerHeart, and optimal normalization to body surface area was explored. Mean annular shapes and the principal components of variation were computed using custom code implemented in a new SlicerHeart module (Annulus Shape Analyzer). Shape was regressed over metrics of age and body surface area, and mean shapes for five age-stratified groups were generated.
The ratio of annular height to commissural width of the mitral valve ("saddle shape") changed significantly throughout age for systolic phases (P < .001) but within a narrow range (median range, 0.20-0.25). Annular metrics changed statistically significantly between the diastolic and systolic phases of the cardiac cycle. Visually, the annular shape was maintained with respect to age and body surface area. Principal-component analysis revealed that the pediatric mitral annulus varies primarily in size (mode 1), ratio of annular height to commissural width (mode 2), and sphericity (mode 3).
The saddle-shaped mitral annulus is maintained throughout childhood but varies significantly throughout the cardiac cycle. The major modes of variation in the pediatric mitral annulus are due to size, ratio of annular height to commissural width, and sphericity. The generation of age- and size-specific mitral annular shapes may inform the development of appropriately scaled absorbable or expandable mitral annuloplasty rings for children.
Cardiometabolic risk accrues across the life course and childhood and adolescence are key periods for effective prevention. Obesity is associated with inflammation in adults, but pediatric data are ...scarce. In a cross-sectional and longitudinal study, we investigated immune cell composition and activation in 31 adolescents with obesity (41.9% male, BMIz>2.5, 14.4 years) and 22 controls with healthy weight (45.1% male, −1.5<BMIz<1.5, 14 years). In those with obesity, we assessed the impact of weight change and correlations between immune profiles and subclinical cardiovascular phenotypes at a 5-year follow-up. Compared to controls, those with obesity had increased monocyte activation and cytokine production upon stimulation. Monocyte transcriptomics demonstrated upregulated inflammatory pathways and downregulated antiviral responses. Weight change was not associated with changes in inflammation. Baseline inflammation correlated with cardiovascular measures at follow-up. Children with obesity have increased inflammation, which associates with worse subsequent subclinical cardiovascular measures. Adjunctive anti-inflammatory interventions may be needed to reverse adverse subclinical cardiovascular phenotypes.
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•31 children with obesity and 22 healthy controls underwent in-depth immune phenotyping•Those with obesity have increased systemic and cellular inflammation•There are no strong effects of change in BMI on inflammation•Childhood inflammation associates with subclinical cardiovascular measures in adolescence
Health sciences; Immunology; Pathophysiology; Disease; Risk factor.
The aim of this study was to examine the effect of resolution from metabolic syndrome (MetS) between youth and adulthood on carotid artery intima-media thickness (IMT) and type 2 diabetes mellitus ...(T2DM).
Published findings demonstrate that youth with MetS are at increased risk of cardio-metabolic outcomes in adulthood. It is not known whether this risk is attenuated in those who resolve their MetS status.
Participants (n = 1,757) from 2 prospective cohort studies were examined as youth (when 9 to 18 years of age) and re-examined 14 to 27 years later. The presence of any 3 components (low high-density lipoprotein cholesterol, high triglycerides, high glucose, high blood pressure, or high body mass index) previously shown to predict adult outcomes defined youth MetS; the harmonized MetS criteria defined adulthood MetS. Participants were classified according to their MetS status at baseline and follow-up and examined for risk of high IMT and T2DM.
Those with MetS in youth and adulthood were at 3.4 times the risk (95% confidence interval: 2.4 to 4.9) of high IMT and 12.2 times the risk (95% confidence interval: 6.3 to 23.9) of T2DM in adulthood compared with those that did not have MetS at either time-point, whereas those that had resolved their youth MetS status by adulthood showed similar risk to those that did not have MetS at either time-point (p > 0.20 for all comparisons).
Although youth with MetS are at increased risk of adult high IMT and T2DM, these data indicate that the resolution of youth MetS by adulthood can go some way to normalize this risk to levels seen in those who have never had MetS.
Two studies were conducted to evaluate the effect of nano chromium picolinate (nCrPic) during heat stress (HS) in sheep. In the initial study, 36 Merino × Poll cross-bred sheep were individually ...penned and allocated to 3 dietary treatments (0, 400 and 800 μg/kg nCrPic) for 8 wk. Body composition was determined at the beginning and end of the experiment using dual energy X-ray absorptiometry. The sheep remained in their dietary groups but were then placed in metabolic cages and randomly allocated within the dietary group to differing ambient temperature regimes, i.e., thermo-neutral (TN) (n = 18) and HS (n = 18), for 3 wk. Dietary nCrPic had no effect on growth performance and body composition during the initial study conducted under TN conditions. Heat stress decreased average daily feed intake (ADFI) (P = 0.002) whereas sheep under HS had reduced average daily gain (ADG) and indeed lost weight (P < 0.001). Dietary nCrPic increased both ADFI (P = 0.041) and ADG (P = 0.049) under both TH and HS conditions such that the performance of sheep receiving supplemental nCrPic and exposed to HS was similar to that of control sheep maintained under TN conditions. Heat stress increased rectal temperature (P < 0.001) and respiration rate (P < 0.001), particularly during the hottest parts of the day as indicated by interactions (P < 0.001) between time of day and thermal treatment. Rectal temperature was lower in sheep fed nCrPic (P = 0.050), particularly under peak HS conditions during the afternoon as indicated by the interactions between dietary nCrPic and time of day (P < 0.001) and dietary nCrPic, thermal treatment and time of day (P = 0.010). Similarly, respiration rate was lower in sheep fed nCrPic under peak HS conditions during the afternoon as indicated by the interactions between dietary nCrPic and thermal treatment (P < 0.001) and dietary nCrPic and time of day (P = 0.030). In conclusion, dietary nCrPic can partially ameliorate the negative effects of HS as indicated by the maintenance of ADFI and decreased physiological responses, such as elevations in rectal temperature and respiration rate.
A 38-year-old woman with sinus venosus atrial septal defect and partial anomalous return of the right upper pulmonary vein underwent a Warden procedure but experienced a large residual defect after ...patch dehiscence. Image-derived 3D modeling informed novel device closure with a Gore Cardioform atrial septal occluder. (Level of Difficulty: Advanced.)
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Abstract Background/objectives We evaluated whether atherosclerotic changes associated with MetS in Australian Aboriginals are reversible in childhood. In addition, we investigated whether heightened ...inflammation is mediating the adverse effects of MetS. Methods The study cohort comprised of 351 children from the Aboriginal Birth Cohort Study (a longitudinal study based in the Northern Territory of Australia) aged 9–13 years at baseline examination who were followed up 6 years later. MetS was defined by at least three of the following parameters within the extreme sex- and age-specific quartile: highest quartile for waist circumference, blood pressure, triglycerides, and glucose, and lowest quartile for HDL-cholesterol. Carotid intima-media thickness (IMT) and C-reactive protein (CRP) were assessed at follow-up. Results Individuals with MetS at baseline or follow-up had increased carotid IMT at follow-up (mean ± SEM 539 ± 3 vs. 561 ± 8 μm, P = 0.007; and 537 ± 3 vs. 567 ± 8 μm, P < 0.0001 respectively). In combined analyses from baseline and follow-up studies, those individuals with MetS only at baseline had partially improved vascular status; their IMT was not significantly increased compared to those without MetS at both time-points (534 ± 3 vs. 550 ± 10 μm, P = 0.09). At the follow-up examination, MetS status was associated with increased IMT levels only among individuals with CRP levels above the median (≥ 2.1 mg/l) (536 ± 5 vs. 573 ± 9 μm, P < 0.0001, P for interaction 0.01). Conclusions MetS in childhood is associated with subclinical atherosclerosis in an Australian Aboriginal population and the effects appear to be mediated by increased inflammation. The extent of atherosclerosis was partially reduced if metabolic status improved during the follow-up.
Abstract Background The American Heart Association recently defined 7 ideal health behaviors and factors that can be used to monitor ideal cardiovascular health (ICH) over time. These relate to ...smoking, physical activity, diet, body mass index (BMI), blood pressure, blood glucose and total cholesterol. Associations between repeated measures of ICH across the life-course with outcomes of subclinical atherosclerosis in adult life have not been reported. Methods and results The sample comprised 1465 children and young adults aged 12 to 24 years (mean age 17.5 years) from the Cardiovascular Risk in Young Finns Study cohort. Participants were followed-up for 21 years since baseline (1986) and had complete ICH data available at baseline and follow-up. Average lifetime ICH index was associated with reduced risk of coronary artery calcification (CAC) (P = 0.0004), high-risk carotid intima-media thickness (IMT) (P = 0.0005) and high-risk carotid distensibility (< 0.0001) in middle age. Participants with persistently low ICH status (lower than the median), as compared with persons with persistently high ICH status (higher than the median), had an increased risk of CAC (P = 0.02), high-risk IMT (P = 0.02), and high-risk distensibility (P < 0.0001). Participants who improved their ICH status from low to high did not have a different risk of CAC (P = 0.90), high-risk IMT (P = 0.25), or high-risk distensibility (P = 0.80) than participants who always had high ICH status. Conclusions The results show that ICH can be lost and regained, and importantly that regaining of ICH has a beneficial effect on cardiometabolic health. Health care providers should work to improve health behaviors especially in those who have lost ICH.
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