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

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

*Corresponding author for this work

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

Original languageEnglish
Article number840790
JournalFrontiers in cardiovascular medicine
Publication statusPublished - 22 Feb 2022


  • cardiac function
  • cardiovascular magnetic resonance imaging
  • hypertension
  • myocardial tissue characterization
  • overweight
  • type 2 diabetes
  • young adults


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