| Regional Left Ventricular Myocardial Dysfunction as a Predictor of Incident Cardiovascular Events MESA (Multi-Ethnic Study of Atherosclerosis). | |
| | |
MedLine Citation:
|
PMID: 21511109 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: We sought to examine the prognostic value of subclinical left ventricular (LV) regional myocardial dysfunction (RMD) measured by magnetic resonance imaging (MRI) among asymptomatic individuals. BACKGROUND: LV RMD, defined as segmental impairment in systolic wall thickening, predicts adverse events in patients with established cardiovascular disease. MRI is highly accurate for detecting subtle RMD, of which the prognostic significance in a large multiethnic asymptomatic population is not known. METHODS: We used MRI to evaluate baseline regional LV myocardial function and prospectively followed a multiethnic (African American, Caucasian, Chinese, and Hispanic) population-based sample of 4,510 men and women without cardiovascular disease for a mean of 4.6 years. Regional myocardial dysfunction was defined as the presence of impaired systolic wall thickening (<10th percentile of segment-specific population distribution) in ≥2 contiguous LV segments within any given coronary artery territory. RESULTS: Baseline prevalence of RMD was 25.6%. Heart failure developed in 34 (1.0%) and 30 (2.6%) participants without and with RMD, respectively (p < 0.001). After adjustment for demographics and traditional risk factors, RMD remained independently associated with incident heart failure (hazard ratio [HR]: 2.62; 95% confidence interval [CI]: 1.56 to 4.39; p < 0.001). The relationship persisted after further adjustment for biomarkers of reported association with cardiovascular disease and indexes of global LV systolic dysfunction and hypertrophy (HR: 1.80; 95% CI: 1.02 to 3.20; p = 0.044). Similarly, RMD independently conferred an increased risk for hard coronary events (myocardial infarction or death from coronary heart disease; HR: 1.75; 95% CI: 1.06 to 2.89; p = 0.029), the composite of hard coronary events and stroke (HR: 1.72; 95% CI: 1.16 to 2.56; p = 0.005), and all atherosclerotic cardiovascular events (HR: 1.50; 95% CI: 1.09 to 2.07; p = 0.012). CONCLUSIONS: Among an asymptomatic multiethnic American cohort, RMD is an independent predictor beyond traditional risk factors and global LV assessment for incident heart failure and atherosclerotic cardiovascular events. The clinical utility of early recognition of this subclinical phenotype deserves further investigation. (Multi-Ethnic Study of Atherosclerosis [MESA]; NCT00005487). |
| | |
Authors:
|
Raymond T Yan; David Bluemke; Antoinette Gomes; Gregory Burke; Steve Shea; Kiang Liu; Hossein Bahrami; Shantanu Sinha; Colin Wu; Veronica Fernandes; Robyn McClelland; João A C Lima |
Related Documents
:
|
16249559 - Ischemia imaging and plaque imaging in diabetes: complementary tools to improve cardiov... 20883229 - Clinical predictors of stress-induced transient left ventricular dilatation in patients... 1889439 - Effects of exercise on the displacement of the atrioventricular plane in patients with ... 14613279 - Coronary artery angiography in systemic lupus erythematosus patients with abnormal myoc... 19101229 - Relation of plaque characteristics defined by coronary computed tomographic angiography... 11988189 - Association of wall thickness of the brachial artery measured with high-resolution ultr... 7479169 - Endocardial fragmented electrogram and prediction of ventricular tachycardia by body su... 2230089 - Cardiac myxoma: the indiana heart institute experience. 6967379 - Prolonging life with coronary bypass surgery in patients with three-vessel disease. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-04-22 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1735-44 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Limbal stem cell deficiency following multiple intravitreal injections.
Next Document: Pericardial fat is associated with atrial fibrillation severity and ablation outcome.