Integrative Observational and Genetic Evidence From the UK Biobank Supports Carotid Intima-Media Thickness as a Window Into Cardiac Remodeling.

BackgroundCarotid intima-media thickness (cIMT) is a noninvasive marker of subclinical atherosclerosis linked to future cardiovascular disease (CVD). However, its relationship with early cardiac remodeling and shared genetic basis with cardiovascular disease remain poorly understood. We investigated the phenotypic and genetic associations between cIMT, aortic and cardiac traits, and cardiovascular disease in the UK Biobank, a large population-based cohort with comprehensive imaging and genetics.MethodsWe analyzed 46 102 participants with carotid ultrasound and cardiac magnetic resonance imaging, excluding those with prevalent heart failure, atrial fibrillation, or stroke. Multivariable linear and Cox regression models assessed associations between common cIMT, aortic and cardiac traits, and incident cardiovascular disease, with effect estimates expressed per 1 SD increase in cIMT. Genetic correlations and pathway enrichment analyses were performed using genome-wide association studies summary statistics.ResultsHigher cIMT was associated with aortic enlargement, left ventricular hypertrophy, and greater chamber volumes, alongside reduced biatrial ejection fractions (all P