The association between adverse childhood experiences and adult cardiac function in the UK Biobank

Juan C Quiroz; Jackie Cooper; Celeste McCracken; Mohammed Y Khanji; Liliana Laranjo; Nay Aung; Aaron Mark Lee; Judit Simon; Theodore Murphy; Luca Biasiolli; Stefan K Piechnik; Pal Maurovich-Horvat; Steffen E Petersen; Zahra Raisi-Estabragh

doi:10.1093/ehjimp/qyae139

The association between adverse childhood experiences and adult cardiac function in the UK Biobank

Eur Heart J Imaging Methods Pract. 2024 Dec 19;2(3):qyae139. doi: 10.1093/ehjimp/qyae139. eCollection 2024 Jul.

Authors

Juan C Quiroz¹, Jackie Cooper², Celeste McCracken^{2

3}, Mohammed Y Khanji^{2

4}, Liliana Laranjo⁵, Nay Aung^{2

4}, Aaron Mark Lee², Judit Simon⁶, Theodore Murphy⁷, Luca Biasiolli³, Stefan K Piechnik³, Pal Maurovich-Horvat⁶, Steffen E Petersen^{2

4

8

9}, Zahra Raisi-Estabragh^{2

4}

Affiliations

¹ Centre for Big Data Research in Health (CBDRH), The University of New South Wales (UNSW), Level 2, AGSM Building G27, Botany St, Kensington, NSW 2033, Australia.
² William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
³ Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford OX3 9DU, UK.
⁴ Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK.
⁵ Faculty of Medicine and Health, Westmead Applied Research Centre (WARC), Sydney Medical School, The University of Sydney, Westmead, Australia.
⁶ MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
⁷ Department of Cardiology and Cardiovascular Imaging, Beacon Hospital, Dublin, Ireland.
⁸ Health Data Research UK, London, UK.
⁹ Alan Turing Institute, London, UK.

Abstract

Aims: The importance of early life factors in determining health in later adulthood is increasingly recognized. This study evaluated the association of adverse childhood experiences (ACEs) with cardiovascular magnetic resonance (CMR) phenotypes.

Methods and results: UK Biobank participants who had completed CMR and the self-reported questionnaire on traumatic childhood experiences were included. Images were analysed using automated pipelines to extract measures of left and right ventricular (LV and RV) structure and function, myocardial character, and arterial compliance. Multivariable linear regression was used to estimate the association of childhood adversity with CMR phenotypes adjusting for age, sex, deprivation, education, obesity, smoking, alcohol intake, exercise level, diabetes, hypertension, and hypercholesterolaemia. Amongst 30 814 participants analysed, 6023 (19.5%) experienced physical abuse, 2746 (8.9%) sexual abuse, 4685 (15.2%) emotional abuse, 6822 (22.1%) emotional neglect, and 4534 (14.7%) physical neglect. Except for physical abuse, women reported greater rates of childhood adversity than men. Collectively, all types of childhood adversity were associated with smaller LV and RV volumes, greater LV mass, a concentric pattern of LV remodelling, poorer LV and RV function, lower aortic compliance, and greater arterial stiffness. Sexual abuse was associated with unhealthy CMR phenotypes in age- and sex-adjusted models, but these relationships were attenuated in fully adjusted models. Physical neglect had the most prominent pattern of adverse cardiovascular remodelling.

Conclusion: ACEs were associated with unhealthy cardiovascular remodelling in adulthood, independent of traditional cardiovascular risk factors. These findings support the consideration of early life factors in cardiovascular disease risk assessment.

Keywords: cardiac remodelling; cardiovascular imaging phenotypes; cardiovascular magnetic resonance; child abuse; childhood maltreatment; neglect.