The Relationship of Left Ventricular Mass and Geometry to Incident Cardiovascular Events

被引:651
作者
Bluemke, David A. [1 ,2 ,3 ]
Kronmal, Richard A. [4 ]
Lima, Joao A. C. [1 ,2 ,3 ]
Liu, Kiang [5 ]
Olson, Jean [6 ]
Burke, Gregory L. [7 ]
Folsom, Aaron R. [8 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Radiol, Div Cardiol, Baltimore, MD 21205 USA
[2] Johns Hopkins Univ, Sch Med, Dept Radiol Sci, Div Cardiol, Baltimore, MD USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Div Cardiol, Baltimore, MD 21205 USA
[4] Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Seattle, WA 98195 USA
[5] Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA
[6] NHLBI, Div Prevent & Populat Sci, Bethesda, MD 20892 USA
[7] Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27103 USA
[8] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA
关键词
heart failure; stroke; coronary heart disease; epidemiology; magnetic resonance imaging; left ventricular hypertrophy;
D O I
10.1016/j.jacc.2008.09.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective The purpose of this study was to evaluate the relationship of left ventricular (LV) mass and geometry measured with cardiac magnetic resonance imaging (MRI) to incident cardiovascular events in the MESA (Multi-Ethnic Study of Atherosclerosis) study. Background MRI is highly accurate for evaluation of heart size and structure and has not previously been used in a large epidemiologic study to predict cardiovascular events. Methods A total of 5,098 participants in the MESA study underwent cardiac MRI at the baseline examination and were followed up for a median of 4 years. Cox proportional hazard models were constructed to predict the end points of coronary heart disease (CHD), stroke, and heart failure (HF) after adjustment for cardiovascular risk factors. Results A total of 216 incident events were observed during the follow-up period. In adjusted models, the end points of incident CHD and stroke were positively associated with increased LV mass-to-volume ratio (CHD, hazard ratio [HR]: 2.1 per g/ml, p = 0.02; stroke, HR: 4.2 per g/ml, p = 0.005). In contrast, LV mass showed the strongest association with incident HF events (HR: 1.4 per 10% increment, p < 0.0001). The HF events occurred primarily in participants with LV hypertrophy, that is, >= 95th percentile of LV mass (HR: 8.6, 95% confidence interval: 3.7 to 19.9, reference group <50th percentile of LV mass). Conclusions The LV size was related to incident HF, stroke, and CHD in this multiethnic cohort. Whereas body size-adjusted LV mass alone predicted incident HF, concentric ventricular remodeling predicted incident stroke and CHD. (J Am Coll Cardiol 2008; 52: 2148-55) (C) 2008 by the American College of Cardiology Foundation
引用
收藏
页码:2148 / 2155
页数:8
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