Traditional cardiovascular risk factors in relation to left ventricular mass, volume, and systolic function by cardiac magnetic resonance imaging - The multiethnic study of atherosclerosis

OBJECTIVES The goal of this study was to examine the cross-sectional associations of cardiovascular risk factors with left ventricular (LV) geometry and systolic function measured by cardiac magnetic resonance imaging (MRI) in the Multiethnic Study of Atherosclerosis (MESA). BACKGROUND Cardiovascular risk factors including hypertension, smoking, and obesity are known to be associated with increased LV mass, but less is known about the association of risk factors with LV systolic function, particularly in populations without clinical cardiovascular disease. METHODS Participants were from 4 racial/ethnic groups and were free of clinical cardiovascular disease. Blood pressure, health habits, body mass index, lipid levels, and glucose abnormalities were assessed and MRI exams performed at baseline (n = 4,869). Multivariable linear regression was used to model the association of risk factors with LV mass, end-diastolic volume, stroke volume, ejection fraction, and cardiac output. RESULTS The mean age was 62 years, and 52% of the participants were women. After adjustment for sociodemographic variables and height, higher systolic blood pressure and body mass index were associated with larger LV mass and volumes. Current smoking and diabetes were associated with greater LV mass (+7.7 g, 95% confidence interval [CI] +5.5 to +9.9 and + 3.5 g, 95% CI + 1.2 to + 5.8, respectively), and with lower stroke volume (- 1.9 ml, 95% Cl -3.3 to -0.5 and -4.5 ml, 95% CI -6.0 to -3.0, respectively) and lower ejection fraction (-1.6%, 95% Cl -2.1 to -1.0 and -0.8%, 95% CI -1.5 to -0.2, respectively). CONCLUSIONS In this cohort free of clinical cardiovascular disease, modifiable risk factors were associated with subclinical alterations in LV size and systolic function as detected by cardiac MRI.