Document Detail


Usefulness of the left ventricular myocardial contraction fraction in healthy men and women to predict cardiovascular morbidity and mortality.
MedLine Citation:
PMID:  22381161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to determine whether depressed myocardial contraction fraction (MCF; ratio of left ventricular [LV] stroke volume to myocardial volume) predicts cardiovascular disease (CVD) events in initially healthy adults. A subset (n = 318, 60 ± 9 years old, 158 men) of the Framingham Heart Study Offspring cohort free of clinical CVD underwent volumetric cardiovascular magnetic resonance imaging in 1998 through 1999. LV ejection fraction (EF), mass, and MCF were determined. "Hard" CVD events consisted of cardiovascular death, myocardial infarction, stroke, or new heart failure. A Cox proportional hazards model adjusting for Framingham Coronary Risk Score was used to estimate hazard ratios for incident hard CVD events for gender-specific quartiles of MCF, LV mass, and LVEF. The lowest quartile of LV mass and highest quartiles of MCF and EF served as referents. Kaplan-Meier survival plots and log-rank test were used to compare event-free survival. MCF was greater in women (0.58 ± 0.13) than in men (0.52 ± 0.11, p <0.01). Nearly all participants (99%) had EF ≥0.55. During an up to 9-year follow-up (median 5.2), 31 participants (10%) developed an incident hard CVD event. Lowest-quartile MCF was 7 times more likely to develop a hard CVD (hazard ratio 7.11, p = 0.010) compared to the remaining quartiles, and increased hazards persisted even after adjustment for LV mass (hazard ratio 6.09, p = 0.020). The highest-quartile LV mass/height 2.7 had a nearly fivefold risk (hazard ratio 4.68, p = 0.016). Event-free survival was shorter in lowest-quartile MCF (p = 0.0006) but not in lowest-quartile LVEF. In conclusion, in a cohort of adults initially without clinical CVD, lowest-quartile MCF conferred an increased hazard for hard CVD events after adjustment for traditional CVD risk factors and LV mass.
Authors:
Michael L Chuang; Philimon Gona; Carol J Salton; Susan B Yeon; Kraig V Kissinger; Susan J Blease; Daniel Levy; Christopher J O'Donnell; Warren J Manning
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-02-28
Journal Detail:
Title:  The American journal of cardiology     Volume:  109     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-01     Completed Date:  2012-07-16     Revised Date:  2013-08-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1454-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage,  diagnostic use
Cardiovascular Diseases / diagnosis,  epidemiology*,  physiopathology
China / epidemiology
Female
Follow-Up Studies
Humans
Injections, Intravenous
Magnetic Resonance Imaging, Cine / utilization*
Male
Middle Aged
Morbidity / trends
Myocardial Contraction / drug effects,  physiology*
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Reference Values
Retrospective Studies
Risk Factors
Stroke Volume*
Survival Rate / trends
Time Factors
Vasodilator Agents / administration & dosage,  diagnostic use
Ventricular Function, Left / drug effects,  physiology*
Grant Support
ID/Acronym/Agency:
N01-HC-38038/HC/NHLBI NIH HHS; N01HC25195/HL/NHLBI NIH HHS; R01 AG17509/AG/NIA NIH HHS; R01 HL070279/HL/NHLBI NIH HHS; Z99 HL999999/HL/NHLBI NIH HHS; ZIA HL006002-06/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine
Comments/Corrections

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