Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 May;12(5):e009018.
doi: 10.1161/CIRCIMAGING.119.009018.

Association of Arsenic Exposure With Cardiac Geometry and Left Ventricular Function in Young Adults

Gernot Pichler  1   2   3 , Maria Grau-Perez  1   2   4 , Maria Tellez-Plaza  2   5   6 , Jason Umans  7   8 , Lyle Best  9 , Shelley Cole  10 , Walter Goessler  11 , Kevin Francesconi  11 , Jonathan Newman  12 , Josep Redon  2   13 , Richard Devereux  14 , Ana Navas-Acien  1
Affiliations
Multicenter Study

Association of Arsenic Exposure With Cardiac Geometry and Left Ventricular Function in Young Adults

Gernot Pichler et al. Circ Cardiovasc Imaging. 2019 May.

Abstract

Background: Arsenic exposure has been related to numerous adverse cardiovascular outcomes. The aim of this study was to investigate the cross-sectional and prospective association between arsenic exposure with echocardiographic measures of left ventricular (LV) geometry and functioning.

Methods: A total of 1337 young adult participants free of diabetes mellitus and cardiovascular disease were recruited from the SHFS (Strong Heart Family Study). The sum of inorganic and methylated arsenic concentrations in urine (ΣAs) at baseline was used as a biomarker of arsenic exposure. LV geometry and functioning were assessed using transthoracic echocardiography at baseline and follow-up.

Results: Mean follow-up was 5.6 years, and median (interquartile range) of ΣAs was 4.2 (2.8-6.9) µg/g creatinine. Increased arsenic exposure was associated with prevalent LV hypertrophy, with an odds ratio (95% CI) per a 2-fold increase in ΣAs of 1.47 (1.05-2.08) in all participants and of 1.58 (1.04-2.41) among prehypertensive or hypertensive individuals. Measures of LV geometry, including LV mass index, left atrial systolic diameter, interventricular septum, and LV posterior wall thickness, were positively and significantly related to arsenic exposure. Among measures of LV functioning, stroke volume, and ejection fraction were associated with arsenic exposure.

Conclusions: Arsenic exposure was related to an increase in LV wall thickness and LV hypertrophy in young American Indians with a low burden of cardiovascular risk factors. The relationship was stronger in participants with prehypertension or hypertension, suggesting that potential cardiotoxic effects of arsenic might be more pronounced in individuals already undergoing cardiovascular adaptive mechanisms following elevated systemic blood pressure.

Keywords: arsenic; blood pressure; echocardiography; heart failure; hypertension; hypertrophy, left ventricular.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Cross-sectional and prospective mean differences and odds ratio of left ventricular (LV) geometry measures by urine arsenic levels.
Lines (shaded areas) represent the adjusted mean differences or odds ratios (95% CI) of left ventricular geometry measures based on restricted cubic splines for log-transformed ΣAs distribution with knots at 10th, 50th, and 90th percentiles. The reference value was set at 10th percentile. Blue lines (blue shaded areas) represent association at baseline, and orange lines (orange shaded areas) represent association at follow-up. Models were adjusted for sex, age, region, smoking (never, former, current), body mass index (continuous), dyslipidemia (no/yes), fasting glucose level (continuous), estimated glomerular filtration rate (continuous), systolic blood pressure (BP; continuous), and BP treatment (no/yes). The histograms in the background represent the distribution of ΣAs. The extreme tails of the histograms were truncated because 3 participants had ΣAs levels <1.0 μ g/g, and 6 participants had ΣAs levels >35.0 μg/g.
Figure 2.
Figure 2.. Dose-response relationships of arsenic and left ventricular functioning measures.
Lines (shaded areas) represent the adjusted mean difference (95% CI) of left ventricular function measures based on restricted cubic splines for log-transformed ΣAs distribution with knots at 10th, 50th, and 90th percentiles. The reference value was set at 10th percentile. Models were adjusted for sex, age, region, smoking (never, former, current), body mass index (continuous), dyslipidemia (no/yes), fasting glucose level (continuous), estimated glomerular filtration rate (continuous), systolic blood pressure (BP; continuous), and BP treatment (no/yes). The histograms in the background represent the distribution of ΣAs. The extreme tails of the histograms were truncated because 3 participants had ΣAs levels <1.0 μ g/g, and 6 participants had ΣAs levels >35.0 μg/g.
See this image and copyright information in PMC

Comment in

  • Arsenic.
    Chowdhury R, van Daalen K. Chowdhury R, et al. Circ Cardiovasc Imaging. 2019 May;12(5):e009185. doi: 10.1161/CIRCIMAGING.119.009185. Circ Cardiovasc Imaging. 2019. PMID: 31060377 No abstract available.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hughes MF, Beck BD, Chen Y, Lewis AS, Thomas DJ. Arsenic exposure and toxicology: a historical perspective. Toxicol Sci. 2011;123:305–332. doi: 10.1093/toxsci/kfr184 - DOI - PMC - PubMed
    1. Huang YK, Tseng CH, Huang YL, Yang MH, Chen CJ, Hsueh YM. Arsenic methylation capability and hypertension risk in subjects living in arseniasis-hyperendemic areas in southwestern Taiwan. Toxicol Appl Pharmacol. 2007;218:135–142. doi: 10.1016/j.taap.2006.10.022 - DOI - PubMed
    1. Navas-Acien A, Silbergeld EK, Pastor-Barriuso R, Guallar E. Arsenic exposure and prevalence of type 2 diabetes in US adults. JAMA. 2008;300:814–822. doi: 10.1001/jama.300.7.814 - DOI - PubMed
    1. Maull EA, Ahsan H, Edwards J, Longnecker MP, Navas-Acien A, Pi J, Silbergeld EK, Styblo M, Tseng CH, Thayer KA, Loomis D. Evaluation of the association between arsenic and diabetes: a National Toxicology Program workshop review. Environ Health Perspect. 2012;120:1658–1670. doi: 10.1289/ehp.1104579 - DOI - PMC - PubMed
    1. Huang YL, Hsueh YM, Huang YK, Yip PK, Yang MH, Chen CJ. Uri-nary arsenic methylation capability and carotid atherosclerosis risk in subjects living in arsenicosis-hyperendemic areas in southwestern Taiwan. Sci Total Environ. 2009;407:2608–2614. doi: 10.1016/j.scitotenv.2008.12.061 - DOI - PubMed

Publication types

MeSH terms

-