title: Ideal cardiovascular health in childhood-Longitudinal associations with cardiac structure and function: The Special Turku Coronary Risk Factor Intervention Project (STRIP) and the Cardiovascular Risk in Young Finns Study (YFS).
abstract: BACKGROUND
  Ideal cardiovascular health (CVH), defined by the American Heart Association, is associated with incident cardiovascular disease in adults. However, association of the ideal CVH in childhood with current and future cardiac structure and function has not been studied.
  
  
  RESULTS
  The sample comprised 827 children participating in the longitudinal Special Turku Coronary Risk Factor Intervention Project (STRIP) and The Cardiovascular Risk in Young Finns Study (YFS). In STRIP, complete data on the seven ideal CVH metrics and left ventricular (LV) mass measured with echocardiography were available at the age of 15 (n=321), 17 (n=309) and 19 (n=283) years. In YFS, the cohort comprised children aged 12-18years (n=506) with complete ideal CVH metrics data from childhood and 25years later in adulthood, and echocardiography performed in adulthood. In STRIP, ideal CVH score was inversely associated with LV mass during childhood (P=0.036). In YFS, childhood ideal CVH score was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume in adulthood (all P<0.01). In addition, improvement of the ideal CVH score between childhood and adulthood was inversely associated with LV mass, LV end-diastolic volume, E/e' ratio, and left atrium end-systolic volume (all P≤0.03).
  
  
  CONCLUSIONS
  Childhood ideal CVH score has a long-lasting effect on cardiac structure and function, and the association is evident already in childhood. Our findings support targeting the ideal CVH metrics as part of primordial prevention of cardiovascular diseases.
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland. Electronic address: tomi.laitinen@utu.fi.
authors.forename: Tomi T
authors.initials: TT
authors.lastname: Laitinen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Saku
authors.initials: S
authors.lastname: Ruohonen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Food and Environmental Sciences, University of Helsinki, Finland.
authors.forename: Vera
authors.initials: V
authors.lastname: Mikkilä
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Mikola
authors.affiliation: Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Department of Pediatrics, University of Oulu, Oulu, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Tossavainen
authors.affiliation: Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Jokinen
authors.affiliation: Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.affiliation: Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Tapani
authors.initials: T
authors.lastname: Rönnemaa
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
authors.forename: Katja
authors.initials: K
authors.lastname: Pahkala
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006304:Health Status; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012955:Societies, Medical; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: Cardiovascular disease prevention; Diastolic dysfunction; Echocardiography; Left ventricular mass; Risk factors