PMID- 32266776 OWN - NLM STAT- MEDLINE DCOM- 20210621 LR - 20210621 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 7 IP - 3 DP - 2020 Jun TI - Age-related longitudinal change in cardiac structure and function in adults at increased cardiovascular risk. PG - 1344-1361 LID - 10.1002/ehf2.12687 [doi] AB - AIM: Heart failure (HF) incidence increases markedly with age. We examined age-associated longitudinal change in cardiac structure and function, and their prediction by age and cardiovascular disease (CVD) risk factors, in a community-based cohort aged >/=60 years at increased CVD risk but without HF. METHODS AND RESULTS: CVD risk factors were recorded in 3065 participants who underwent a baseline echocardiographic examination, of whom 2358 attended a follow-up examination 3.8 [median, inter-quartile range (IQR) 3.5, 4.2] years later. Median age was 71 (IQR 67, 76) years and 55% of participants were male. Age was associated with longitudinal increase in left ventricular (LV) mass index (LVMI); decrease in LV volumes; increase in LV ejection fraction; decrease in mitral annular systolic velocity; decrease in diastolic function (decreased mitral early diastolic annular velocity (e'); and increase in left atrial volume index, mitral peak early diastolic flow velocity (E)/e' ratio, and tricuspid regurgitant velocity (TR(Vmax) ) in men and women, except for TR(Vmax) in men). In multivariable analysis, longitudinal increase in LVMI was explained by CVD risk factors alone, whereas age, together with CVD risk factors, independently predicted longitudinal change in all other echocardiographic parameters. CVD risk factors were differentially associated with longitudinal change in different echocardiographic parameters. CONCLUSIONS: Whereas the increase in LVMI with age was explained by CVD risk factors alone, age, together with risk factors, independently predicted longitudinal change in all other echocardiographic parameters, providing evidence for age-specific mechanisms of change in cardiac structure and function as people age. Age-associated change in LVMI, LV volumes, and diastolic function resembled what might be expected for the evolution of HF with preserved ejection fraction. Given the differential association of different CVD risk factors with longitudinal change in different echocardiographic parameters, therapies aimed at attenuation of age-associated change in cardiac structure and function, and HF evolution, will likely need to address multiple CVD risk factors. CI - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. FAU - Gong, Fei Fei AU - Gong FF AD - St. Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia. AD - University of Melbourne, Parkville, Victoria, Australia. AD - St. Vincent's Hospital, Melbourne, Victoria, Australia. FAU - Coller, Jennifer M AU - Coller JM AD - St. Vincent's Hospital, Melbourne, Victoria, Australia. FAU - McGrady, Michele AU - McGrady M AD - Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. FAU - Boffa, Umberto AU - Boffa U AUID- ORCID: 0000-0001-6261-8891 AD - School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. FAU - Shiel, Louise AU - Shiel L AD - School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia. FAU - Liew, Danny AU - Liew D AD - School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia. FAU - Stewart, Simon AU - Stewart S AUID- ORCID: 0000-0001-9032-8998 AD - Torrens University Australia, Adelaide, South Australia, Australia. FAU - Owen, Alice J AU - Owen AJ AD - School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia. FAU - Krum, Henry AU - Krum H AD - School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia. FAU - Reid, Christopher M AU - Reid CM AUID- ORCID: 0000-0001-9173-3944 AD - School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia. AD - School of Public Health, Curtin University, Bentley, Western Australia, Australia. FAU - Prior, David L AU - Prior DL AUID- ORCID: 0000-0002-3243-7026 AD - University of Melbourne, Parkville, Victoria, Australia. AD - St. Vincent's Hospital, Melbourne, Victoria, Australia. FAU - Campbell, Duncan J AU - Campbell DJ AUID- ORCID: 0000-0002-6896-7571 AD - St. Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia. AD - University of Melbourne, Parkville, Victoria, Australia. AD - St. Vincent's Hospital, Melbourne, Victoria, Australia. LA - eng GR - GTN0559010/National Health and Medical Research Council/International GR - GTN1044619/National Health and Medical Research Council/International GR - GTN1092642/National Health and Medical Research Council/International GR - GTN1045862/National Health and Medical Research Council/International GR - GTN1136372/National Health and Medical Research Council/International GR - GTN1041796/National Health and Medical Research Council/International GR - GTN0620241/National Health and Medical Research Council/International GR - GNT0519456/National Health and Medical Research Council/International GR - GTN0395508/National Health and Medical Research Council/International GR - Victorian Government's Operational Infrastructure Support Program/International GR - St. Vincent's Institute of Medical Research/International GR - St. Vincent's Hospital Melbourne/International GR - University of Melbourne/International GR - Y15G-CAMD/Diabetes Australia Research Trust/International GR - G 07M 3198/National Heart Foundation of Australia/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200407 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM MH - Adult MH - Aged MH - *Cardiovascular Diseases/epidemiology MH - Female MH - Heart Disease Risk Factors MH - Humans MH - Male MH - Middle Aged MH - Risk Factors MH - Stroke Volume MH - Ventricular Function, Left PMC - PMC7261573 OTO - NOTNLM OT - Aging OT - Echocardiography OT - Heart failure OT - Risk factors COIS- Bupa Australia was involved in the study design, recruitment of participants, and funding but was not involved in the data collection, analysis or interpretation, or writing of the article. Bupa Australia had no control or influence over the decision to submit the final manuscript for publication. Boffa was an employee of Bupa Australia. Liew received honoraria from Pfizer, Sanofi, Astra-Zeneca, Abbott, Bayer, MSD, GSK, Novartis, and Nycomed. Stewart received unrestricted educational grants from Schering Plough and Boehringer Ingelheim and was Principal Investigator of the Novartis-sponsored Valsartan Intensified Primary Care Reduction of Blood Pressure (VIPER-BP) Study. Krum received support from Novartis, Bristol-Myers Squibb, and Ardian/Medtronic. Prior received payments from Johnson & Johnson, Bayer, and Novartis for lectures. The remaining authors have no disclosures to report. EDAT- 2020/04/09 06:00 MHDA- 2021/06/22 06:00 PMCR- 2020/04/07 CRDT- 2020/04/09 06:00 PHST- 2020/01/08 00:00 [received] PHST- 2020/02/21 00:00 [revised] PHST- 2020/03/08 00:00 [accepted] PHST- 2020/04/09 06:00 [pubmed] PHST- 2021/06/22 06:00 [medline] PHST- 2020/04/09 06:00 [entrez] PHST- 2020/04/07 00:00 [pmc-release] AID - EHF212687 [pii] AID - 10.1002/ehf2.12687 [doi] PST - ppublish SO - ESC Heart Fail. 2020 Jun;7(3):1344-1361. doi: 10.1002/ehf2.12687. Epub 2020 Apr 7.