Association between knee cartilage degradation and cardiac remodeling A cross-sectional analysis in a community-based cohort

Abstract

Objectives: Osteoarthritis, a leading cause of disability, has been epidemiologically linked to cardiovascular disease (CVD), yet the relationship between structural cartilage degeneration and cardiac remodeling remains poorly characterized. This cross-sectional study investigates whether knee cartilage degradation, quantified via ultrasonography, correlates with echocardiographic markers of subclinical cardiovascular dysfunction.

Methods: Middle-aged and elderly people aged 35 to 75 years who met the inclusion criteria were enrolled. Knee cartilage degradation was scored (0-3 per side) using ultrasound, with total scores categorized as normal (0-3, n = 1,041) or degraded (≥ 4, n = 430). Cardiac structure and function parameters, including left ventricular ejection fraction, left atrial volume index (LAVI), left ventricular mass index, and diastolic function (mitral valve e' and E/e' ratio), were measured by echocardiography. Group comparison, logistic regression, subgroup and sensitivity analyses, and XGBoost machine learning were used to assess associations and feature importance.

Results: Participants with degraded cartilage were older (median age 64 vs. 58 years, p < 0.001) and had a lower male proportion (31% vs. 45%, p < 0.001). The degraded group exhibited a significantly higher median LAVI (29 vs. 27mL/m², p < 0.001). Subgroup and sensitivity analyses confirmed that the association with LAVI was robust. XGBoost analysis identified cartilage degradation as an important contributor to LAVI (standardized gain value 4.89%, ranking 10^th among 24 variables).

Conclusions: Knee cartilage degeneration is associated with left atrial enlargement. These findings underscore the potential role of osteoarthritis-related structural joint damage in subclinical cardiac remodeling, offering a foundation for future exploration of comprehensive care strategies.

Keywords

cardiac remodeling / knee cartilage degeneration / left atrial volume index / osteoarthritis / population study

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