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RESEARCH PRODUCT

Association of Arsenic Exposure With Cardiac Geometry and Left Ventricular Function in Young Adults

Lyle G. BestMaria Tellez-plazaMaria Tellez-plazaAna Navas-acienRedon JosepJason G. UmansRichard B. DevereuxMaria Grau-perezMaria Grau-perezKevin A. FrancesconiWalter GoesslerJonathan D. NewmanG. PichlerShelley A. Cole

subject

Cardiac geometrymedicine.medical_specialtyVentricular functionbusiness.industrychemistry.chemical_element030204 cardiovascular system & hematology010501 environmental sciencesmedicine.disease01 natural sciences03 medical and health sciences0302 clinical medicineBlood pressurechemistryInternal medicineHeart failureCardiologyMedicineRadiology Nuclear Medicine and imagingYoung adultCardiology and Cardiovascular MedicinebusinessARSENIC EXPOSURECardiovascular outcomesArsenic0105 earth and related environmental sciences

description

Background: Arsenic exposure has been related to numerous adverse cardiovascular outcomes. The aim of this study was to investigate the cross-sectional and prospective association between arsenic exposure with echocardiographic measures of left ventricular (LV) geometry and functioning. Methods: A total of 1337 young adult participants free of diabetes mellitus and cardiovascular disease were recruited from the SHFS (Strong Heart Family Study). The sum of inorganic and methylated arsenic concentrations in urine (ΣAs) at baseline was used as a biomarker of arsenic exposure. LV geometry and functioning were assessed using transthoracic echocardiography at baseline and follow-up. Results: Mean follow-up was 5.6 years, and median (interquartile range) of ΣAs was 4.2 (2.8–6.9) µg/g creatinine. Increased arsenic exposure was associated with prevalent LV hypertrophy, with an odds ratio (95% CI) per a 2-fold increase in ΣAs of 1.47 (1.05–2.08) in all participants and of 1.58 (1.04–2.41) among prehypertensive or hypertensive individuals. Measures of LV geometry, including LV mass index, left atrial systolic diameter, interventricular septum, and LV posterior wall thickness, were positively and significantly related to arsenic exposure. Among measures of LV functioning, stroke volume, and ejection fraction were associated with arsenic exposure. Conclusions: Arsenic exposure was related to an increase in LV wall thickness and LV hypertrophy in young American Indians with a low burden of cardiovascular risk factors. The relationship was stronger in participants with prehypertension or hypertension, suggesting that potential cardiotoxic effects of arsenic might be more pronounced in individuals already undergoing cardiovascular adaptive mechanisms following elevated systemic blood pressure.

https://doi.org/10.1161/circimaging.119.009018