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Multiple Prior Live Births are Associated with Cardiac Remodeling and Heart Failure Risk in Women.
Monday,2023-01-30 11:59 America/Los_Angeles — ecterry
| Title | Multiple Prior Live Births are Associated with Cardiac Remodeling and Heart Failure Risk in Women. |
| Publication Type | Journal Article |
| Year of Publication | 2023 |
| Authors | Sarma, AA, Paniagua, SM, Lau, ES, Wang, D, Liu, EE, Larson, MG, Hamburg, NM, Mitchell, GF, Kizer, J, Psaty, BM, Allen, NB, A Lely, T, Gansevoort, RT, Rosenberg, E, Mukamal, K, Benjamin, EJ, Vasan, RS, Cheng, S, Levy, D, de Boer, RA, Gottdiener, JS, Shah, SJ, Ho, JE |
| Journal | J Card Fail |
| Date Published | 2023 Jan 10 |
| ISSN | 1532-8414 |
| Abstract | <p><b>INTRODUCTION: </b>Greater parity has been associated with cardiovascular disease risk, though effects on cardiac remodeling and heart failure risk remain unclear.</p><p><b>METHODS: </b>We examined the association of number of live births and echocardiographic measures of cardiac structure and function in participants of the Framingham Heart Study (FHS) using multivariable linear regression. We next examined the association of parity with incident heart failure with preserved (HFpEF) or reduced (HFrEF) ejection fraction using a Fine-Gray subdistribution hazards model in a pooled analysis of n=12,635 participants of FHS, the Cardiovascular Health Study, the Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular Endstage Disease. Secondary analyses included major CVD, MI, and stroke.</p><p><b>RESULTS: </b>Among n=3931 FHS participants (mean age 48 ± 13 years), higher number of live births was associated with worse LV fractional shortening (multivariable β -1.11 (0.31), p= 0.0005 in ≥ 5 live births vs nulliparous women) and worse cardiac mechanics including global circumferential strain and longitudinal and radial dyssynchrony (p< 0.01 for all comparing ≥ 5 live births vs nulliparity). When examining HF subtypes, women with ≥5 live births were at higher risk of developing future HFrEF compared with nulliparous women (HR 1.93, 95% CI 1.19-3.12, p=0.008); by contrast, a lower risk of HFpEF was observed (HR 0.58, 95% CI 0.37-0.91, p=0.02).</p><p><b>CONCLUSIONS: </b>Greater number of live births are associated with worse cardiac structure and function. While there was no association with overall HF, a higher number of live births was associated with greater risk for incident HFrEF.</p> |
| DOI | 10.1016/j.cardfail.2022.12.014 |
| Alternate Journal | J Card Fail |
| PubMed ID | 36638956 |
| Grant List | K23 HL159243 / HL / NHLBI NIH HHS / United States |
ePub date:
23/01