Adverse Left Ventricular Remodeling and Age Assessed with Cardiac MR Imaging: The Multi-Ethnic Study of Atherosclerosis

Abstract

).q RSNA, 2015 Purpose:To evaluate age-related left ventricular (LV) remodeling during longitudinal observation of a large cohort of asymptomatic individuals who were free of clinical cardiovascular disease at baseline. Materials and Methods:The applicable institutional review boards approved this study, and all participants gave informed consent. Cardiac magnetic resonance (MR) imaging was used to identify longitudinal changes in LV structure and function in 2935 participants who underwent baseline and follow-up cardiac MR imaging in the Multi-Ethnic Study of Atherosclerosis. Participants were free of clinical cardiovascular disease at baseline. Participants who experienced an incident coronary heart disease event were excluded. Data were analyzed with multivariable mixed-effects regression models in which the outcome was cardiac MR imaging measurement, and the covariates included follow-up time and cardiac risk factors. Results:Participants were aged 54-94 years at follow-up, and 53% of the participants were women. Median time between baseline and follow-up cardiac MR imaging was 9.4 years. Over this period, LV mass increased in men and decreased slightly in women (8.0 and 21.6 g per decade, respectively; P , .001). In both men and women, LV enddiastolic volume decreased (29.8 and 213.3 mL per decade, respectively; P , .001), stroke volume decreased (28.8 and 28.6 mL per decade, respectively; P , .001), and mass-to-volume ratio increased (0.14 and 0.11 g/mL per decade, respectively; P , .001). Change in LV mass was positively associated with systolic blood pressure and body mass index and negatively associated with treated hypertension and high-density lipoprotein cholesterol level. In men, the longitudinal LV mass increase was in contrast to a cross-sectional pattern of LV mass decrease. Conclusion:As patients age, the LV responds differently in its mass and volume between men and women, although both men and women experience increased concentric LV remodeling with age. In men, the opposition of longitudinal and cross-sectional changes in LV mass highlights the importance of longitudinal study.q RSNA, 2015

Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study

“…31,32 Similarly, obesity has been found to be associated with increased LV mass and decreased LV volumes. 33 While no differences were detected regarding the prevalence of dyslipidaemia and smoking between males and females in our study, we observed that women had a lower BMI than men, and a significant decrease in BMI with increasing age was seen in males but not in females. However, BMI was not found to have significant independent influence on LVEF in our study, thus, the observed gender-specific changes in LV systolic function occurring with advancing age do not seem to depend on an increase in BMI.…”

Cardiac Motion Evolution Model for Analysis of Functional Changes Using Tensor Decomposition and Cross-Sectional Data

“…As shown in [53], this may not be a valid assumption. Hence, future validation of this approach by use of longitudinal data is needed in order to draw clinical conclusions.…”

Stiff Arteries, Stiff Ventricles

“…21 It would be appealing to combine complementary cardiac magnetic resonance data sets from the MESA cohort, including feature-tracking for strain assessment in each axis, to establish a comprehensive picture of longitudinal adaptations in LV mass, function, and aortic stiffness-findings that may not always be congruent with cross-sectional associations. 22 The right heart is also an important determinant of outcome in heart failure, and there is emerging evidence that a similar relationship exists between pulmonary artery stiffness and right ventricular function to that observed in the systemic circulation. 23 Convincing data are still required on the putative feedback mechanisms between aortic and ventricular dysfunction, what processes might initiate and amplify the progression to heart failure in the general population, or any certainty as to whether outcomes in heart failure may be improved by modifying aortic elasticity independent of conventional risk factors.…”

“…21 It would be appealing to combine complementary cardiac magnetic resonance data sets from the MESA cohort, including feature-tracking for strain assessment in each axis, to establish a comprehensive picture of longitudinal adaptations in LV mass, function, and aortic stiffness-findings that may not always be congruent with cross-sectional associations. 22 The right heart is also an important determinant of outcome in heart failure, and there is emerging evidence that a similar relationship exists between pulmonary artery stiffness and right ventricular function to that observed in the systemic circulation. …”