Regional Left Ventricular Myocardial Dysfunction as a Predictor of Incident Cardiovascular Events

Yan, Raymond T.; Bluemke, David A.; Gomes, Antoinette S.; Burke, Gregory L.; Shea, Steve; Liu, Kiang; Bahrami, Hossein; Sinha, Shantanu; Wu, Colin O.; Fernandes, Verônica; McClelland, Robyn L.; Lima, João A.C.

doi:10.1016/j.jacc.2010.10.060

Cited by 31 publications

(26 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CMR imaging was performed at 1.5 Tesla at the index examination as previously described [15, 16]. Assessment of ventricular function was performed using electrocardiographically-gated fast gradient echo cine images (repetition time 6 msec, minimal echo time, flip angle 20 ° , 8 mm slice thickness with 2 mm gap, matrix 256×160, field of view adjusted to body size, receiver bandwidth 32 kHz).…”

Section: Methodsmentioning

confidence: 99%

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Shah

Abbasi

Heydari

et al. 2013

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Objectives We assessed in the Multi-Ethnic Study of Atherosclerosis (MESA) whether impaired fasting glucose, insulin resistance, and waist-to-hip ratio had effects on cardiac remodeling, independent of obesity. Background Recent studies suggest that central obesity and insulin resistance may be primary mediators of obesity-related cardiac remodeling independent of body mass index (BMI). Methods We investigated 4,364 individuals without diabetes in MESA. Impaired fasting glucose (IFG: 100-125 mg/dl) or insulin resistance (by homeostatic model assessment of insulin resistance, HOMA-IR) and waist-to-hip ratio (WHR) were used for cardiometabolic phenotyping. Multivariate linear regression analysis was used to determine the effects of the cardiometabolic markers on LV remodeling, assessed primarily through the LV mass-to-volume ratio obtained by cine cardiac magnetic resonance imaging. Results Individuals with IFG were more likely to be older, hypertensive, with increased prevalence of cardiometabolic risk factors regardless of BMI. In each quartile of BMI, individuals with above-median HOMA-IR, above-median WHR, or IFG had a higher LV mass-to-volume ratio (p<0.05 for all). HOMA-IR (p<0.0001), WHR (p<0.0001), and the presence of IFG (p=0.04), but not BMI (p=0.24), were independently associated with LV mass-to-volume ratio after adjustment for age, gender, hypertension, race, and dyslipidemia. Conclusions Insulin resistance and waist-to-hip ratio are associated with concentric LV remodeling independent of BMI. These results support the emerging hypothesis that the cardiometabolic phenotype, defined by insulin resistance and central obesity, may play a critical role in LV remodeling independently of BMI.

show abstract

Section: Methodsmentioning

confidence: 99%

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Shah

Abbasi

Heydari

et al. 2013

Journal of the American College of Cardiology

View full text Add to dashboard Cite

show abstract

“…However, myocardial dysfunction in its early stage can occur at a regional level and may thus result in only minimal decrease of EF that cannot be easily detected with standard diagnostic tools. Previous clinical studies have proven that the impaired of local left ventricle (LV) wall thickening in systole, which was semi-quantitatively identified by using either echocardiography or magnetic resonance (MR) imaging, is associated with a high incidence of CHF and cardiovascular events [1, 2]. In asymptomatic subjects with prominent cardiovascular risk factors, such as diabetes mellitus (DM) or obesity, impaired regional myocardial motion can be observed without a decrease of EF [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Heart deformation analysis: measuring regional myocardial velocity with MR imaging

Lin

Collins

Chowdhary

et al. 2016

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

The aim of the present study was to test the hypothesis that that heart deformation analysis (HDA) may serve as an alternative for the quantification of regional myocardial velocity. Nineteen healthy volunteers (14 male and 5 female) without documented cardiovascular diseases were recruited following the approval of the institutional review board (IRB). For each participant, cine images (at base, mid and apex levels of the left ventricle [LV]) and tissue phase mapping (TPM, at same short-axis slices of the LV) were acquired within a single magnetic resonance (MR) scan. Regional myocardial velocities in radial and circumferential directions acquired with HDA (Vrr and Vcc) and TPM (Vr and VΦ) were measured during the cardiac cycle. HDA required shorter processing time compared to TPM (2.3 ± 1.1 min/case vs. 9.5 ± 3.7 min/case, p < 0.001). Moderate to good correlations between velocity components measured with HDA and TPM could be found on multiple myocardial segments (r = 0.460 -0.774) and slices (r = 0.409 -0.814) with statistical significance (p < 0.05). However, significant biases of velocity measures at regional myocardial areas between HDA and TPM were also noticed. By providing comparable velocity measures as TPM does, HDA may serve as an alternative for measuring regional myocardial velocity with a faster image processing procedure.

show abstract

“…Furthermore, subclinical abnormalities in LV function assessed by echocardiography have been shown to predict all‐cause death in the Framingham Heart Study29 and among Olmsted County residents 30. Similarly, regional myocardial dysfunction detected by echocardiography predicted cardiovascular death in the Strong Heart Study,31 whereas regional myocardial dysfunction measured with cardiac magnetic resonance imaging predicted coronary artery disease–related death in the MESA cohort 32. Whereas these previous studies are valuable, the application of noninvasive imaging is limited by cost and widespread availability.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Medina‐Lezama

Narvaez‐Guerra

Herrera‐Enriquez

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundBlood pressure is determined by the interactions between the heart and arterial properties, and subjects with identical blood pressure may have substantially different hemodynamic determinants. Whether arterial hemodynamic indices quantified by impedance cardiography (ICG), a simple operator‐independent office procedure, independently predict all‐cause mortality in adults from the general population, and specifically among those who do not meet criteria for American College of Cardiology/American Heart Association stage 2 hypertension, is currently unknown.Methods and ResultsWe studied 1639 adults aged 18 to 80 years from the general population. We used ICG to measure hemodynamic parameters and metrics of cardiac function. We assessed the relationship between hemodynamic parameters measured at baseline and all‐cause mortality over a mean follow‐up of 10.9 years. Several ICG parameters predicted death. The strongest predictors were total arterial compliance index (standardized hazard ratio=0.38; 95% confidence interval=0.31–0.46; P<0.0001) and indices of cardiac contractility: velocity index (standardized hazard ratio=0.45; 95% confidence interval=0.37–0.55; P<0.0001) and acceleration index (standardized hazard ratio=0.44; 95% confidence interval=0.35–0.55; P<0.0001). These remained independently predictive of death after adjustment for multiple confounders, as well as systolic and diastolic blood pressure. Among subjects without stage 2 hypertension (n=1563), indices of cardiac contractility were independently predictive of death and identified a subpopulation (25% of non‐stage‐2 hypertensives) that demonstrated a high 10‐year mortality risk, equivalent to that of stage 2 hypertensives.ConclusionsHemodynamic patterns identified by ICG independently predict mortality in the general population. The predictive value of ICG applies even in the absence of American College of Cardiology/American Heart Association stage 2 hypertension and identifies higher‐risk individuals who are in earlier stages of the hypertension continuum.

show abstract

Regional Left Ventricular Myocardial Dysfunction as a Predictor of Incident Cardiovascular Events

Cited by 31 publications

References 38 publications

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Insulin Resistance, Subclinical Left Ventricular Remodeling, and the Obesity Paradox

Heart deformation analysis: measuring regional myocardial velocity with MR imaging

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Contact Info

Product

Resources

About