Determinants of cardiovascular autonomic regulation and cardiac structure in a middle-aged population:influence of early growth related factors and life course physical activity

• Main Author: Korpela, N. (Nelli)
• Other Authors: Kiviniemi, A. (Antti M.), Tulppo, M. (Mikko P.), Huikuri, H. (Heikki V.)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2020
• Subjects: birth weight; body mass index; cardiovascular autonomic regulation; cardiovascular disease; childhood growth; cohort study; left ventricular hypertrophy; left ventricular structure; physical activity; fyysinen aktiivisuus; kohorttitutkimus; lapsuuden kasvu; painoindeksi; sydämen autonominen säätely; sydän- ja verisuonisairaudet; syntymäpaino; vasemman kammion hypertrofia; vasemman kammion rakenne; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526226231

Abstract There is increasing evidence suggesting that cardiovascular diseases have an early origin, already beginning during fetal life and in childhood. The autonomic nervous system plays an important role in the pathophysiology of various cardiovascular manifestations and cardiac left ventricular structure is related to cardiovascular morbidity and mortality in adulthood. The aim of this thesis was to investigate associations between fetal and childhood growth and cardiovascular autonomic regulation as well as cardiac structure and function in a middle-aged general population. This thesis also aimed to examine the association between life course physical activity and cardiovascular autonomic regulation in midlife. The study population was based on the prospective population-based Northern Finland 1966 Birth Cohort. This cohort has been followed from early gestation and frequent anthropometric measurements have been taken of the participants in infancy and childhood. At 46 years of age, 5861 participants underwent a comprehensive cardiometabolic examination, including an analysis of heart rate variability (n=5679), and in a subsample also an analysis of baroreflex sensitivity (n=2726) and an echocardiographic examination (n=1155). The results revealed that a higher birth weight in males was related to reduced vagal regulation of heart rate in midlife, but birth weight did not have a substantial association with cardiac left ventricular structure or function in midlife. Early growth patterns, particularly earlier adiposity rebound and higher body mass index at adiposity peak and at adiposity rebound, were associated with reduced cardiovascular vagal regulation and modifications in cardiac structure in midlife. A high level of life course physical activity was independently related to increased cardiovascular vagal regulation in females in midlife, while in males this association was mediated by other lifestyle and health related factors. In conclusion, this study indicates that early growth patterns are related ...