The associations between cardiovascular disease (CVD) risk factors and the biventricular geometry of the right ventricle (RV) and left ventricle (LV) have been difficult to assess, due to subtle and complex shape changes. We sought to quantify reference RV morphology as well as biventricular variations associated with common cardiovascular risk factors.
A biventricular shape atlas was automatically constructed using contours and landmarks from 4329 UK Biobank cardiovascular magnetic resonance (CMR) studies. A subdivision surface geometric mesh was customized to the contours using a diffeomorphic registration algorithm, with automatic correction of slice shifts due to differences in breath-hold position. A reference sub-cohort was identified consisting of 630 participants with no CVD risk factors. Morphometric scores were computed using linear regression to quantify shape variations associated with four risk factors (high cholesterol, high blood pressure, obesity and smoking) and three disease factors (diabetes, previous myocardial infarction and angina).
The atlas construction led to an accurate representation of 3D shapes at end-diastole and end-systole, with acceptable fitting errors between surfaces and contours (average error less than 1.5?mm). Atlas shape features had stronger associations than traditional mass and volume measures for all factors (p <?0.005 for each). High blood pressure was associated with outward displacement of the LV free walls, but inward displacement of the RV free wall and thickening of the septum. Smoking was associated with a rounder RV with inward displacement of the RV free wall and increased relative wall thickness.
Morphometric relationships between biventricular shape and cardiovascular risk factors in a large cohort show complex interactions between RV and LV morphology. These can be quantified by z-scores, which can be used to study the morphological correlates of disease.
Description of cardiovascular phenotype in the UK Biobank population based on cardiovascular magnetic resonance and carotid ultrasound
Imaging of the heart and blood vessels is performed in a large subset of the UK Biobank cohort. Many measures defining the state of the heart and blood vessels can be derived from the images acquired. These measures are influenced by various health conditions and modifiable and non-modifiable factors, such as age, gender and ethnicity. The aim of this proposal is to describe the measures of the heart and blood vessel in the UK Biobank population and investigate how much modifiable and non-modifiable factors influence them. All new data will be made available for future research. Knowing the reference ranges for common imaging measures of the heart and circulation and how they are influenced by factors, such as age, gender, ethnicity, risk factors for heart attacks and strokes, is key for improving making diagnoses and predicting health outcomes. Descriptive statistics will be performed for all image derived phenotypes (IDPs) from the cardiovascular magnetic resonance (CMR) and carotid ultrasound images. We will perform subgroup analysis for important clinical factors, such as age, gender, cardiovascular risk, chronic conditions (e.g. Diabetes). We will apply descriptive statistics to a subpopulation considered `healthy without cardiovascular disease or presence of modifiable risk factors`. Univariate and multivariate regression analysis will be used to assess relationships between IDPs and relevant co-variates. We will also assess intra- and inter-observer variability for IDP measurement when repeat analysis is available. Initial 5000 subjects from the imaging enhancement study.
|Lead investigator:||Professor Steffen Petersen|
|Lead institution:||Queen Mary University of London|
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