Von Willebrand Factor and the Right Ventricle (the MESA-Right Ventricle Study)

Leary, Peter J.; Barr, R. Graham; Bluemke, David A.; Bristow, Michael R.; Hough, Catherine L.; Kronmal, Richard A.; Lima, João A.C.; McClelland, Robyn L.; Tracy, Russell P.; Kawut, Steven M.

doi:10.1016/j.amjcard.2012.08.022

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…The results of our study, namely, that increased vascular stiffness markers were generally associated with smaller RV volumes and lower RV mass , were contrary to our original hypotheses, which was based on observations of the response of RV in the setting of HFpEF . It is notable that previous investigations in MESA‐RV have similarly revealed relationships between smaller RV size and aging, risk of incident dyspnea, emphysema/chronic obstructive pulmonary disease, and inflammatory biomarkers . Our findings serve as a caution to extrapolating information from disease states to preclinical stages of disease given that the consistency between inflammatory biomarkers and vascular stiffness and decreased RV size imply distinct pathophysiological processes in individuals without clinical cardiovascular disease.…”

Section: Discussioncontrasting

confidence: 99%

Association of Systemic Arterial Properties With Right Ventricular Morphology: The Multi‐Ethnic Study of Atherosclerosis (MESA)‐Right Ventricle Study

Al‐Naamani

Chirinos

Zamani

et al. 2016

JAHA

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BackgroundSystemic arterial stiffness is recognized as a major contributor to development of left ventricular dysfunction and failure; however, the relationship of systemic arterial properties and the right ventricle (RV) is unknown.Methods and ResultsThe associations between systemic arterial measures (total arterial compliance [TAC], systemic vascular resistance [SVR], and aortic augmentation index [AI]) and RV morphology (mass, end‐systolic [RVESV] and end‐diastolic volume [RVEDV], and ejection fraction [RVEF]) were examined using data from the Multi‐Ethnic Study of Atherosclerosis. All analyses were adjusted for anthropometric, demographic, and clinical variables and the corresponding left ventricular parameter. A total of 3842 subjects without clinical cardiovascular disease were included with a mean age of 61 years, 48% male, 39% non‐Hispanic white, 25% Chinese‐American, 23% Hispanic, and 13% black. RV measures were within normal range for age and sex. A 1‐mL/mm Hg decrease in TAC was associated with 3.9‐mL smaller RVESV, 7.6‐mL smaller RVEDV, and 2.4‐g lower RV mass. A 5‐Wood‐unit increase in SVR was associated with 0.6‐mL decrease in RVESV, 1.7‐mL decrease in RVEDV, and 0.4‐g decrease in RV mass. A 1% increase in AI was associated with 0.2‐mL decrease in RVEDV. We found significant effect modification by age, sex, and race for some of these relationships, with males, whites, and younger individuals having greater decreases in RV volumes and mass.ConclusionsMarkers of increased systemic arterial load were associated with smaller RV volumes and lower RV mass in a population of adults without clinical cardiovascular disease.

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Section: Discussioncontrasting

confidence: 99%

Association of Systemic Arterial Properties With Right Ventricular Morphology: The Multi‐Ethnic Study of Atherosclerosis (MESA)‐Right Ventricle Study

Al‐Naamani

Chirinos

Zamani

et al. 2016

JAHA

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“…Other mechanisms that reduce blood return to the thorax in severe COPD, affecting filling of both ventricles and the pulmonary vasculature, include a reduced gradient in pressure between the abdomen and chest and abnormal diaphragm orientation compressing the vena cava (42). Alternatively, intrinsic RV diastolic dysfunction, possibly related to increased inflammation or endothelial dysfunction, could decrease RV filling (43, 44). These novel mechanisms may suggest innovative approaches which target diastolic function (for example, soluble guanylate cyclase activators) to treat the cardiac component of exercise limitation in these patients.…”

Section: Discussionmentioning

confidence: 99%

Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema

Kawut

Poor

Parikh

et al. 2014

Journal of the American College of Cardiology

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Background The classic cardiovascular complication of chronic obstructive pulmonary disease (COPD) is cor pulmonale, or enlargement of the right ventricle (RV). Most studies of cor pulmonale were conducted decades ago. Objective We aimed to examine RV changes in contemporary COPD and emphysema using cardiac magnetic resonance imaging (MRI). Methods We performed a case-control study nested predominantly in two general population studies of 310 participants with COPD and controls ages 50–79 years with ≥ 10 pack-years of smoking and who were free of clinical cardiovascular disease. RV volumes and mass were assessed using MRI. COPD and COPD severity were defined by standard spirometric criteria. Percent emphysema was defined as percent of lung regions <-950 Hounsfield units on full-lung computed tomography; emphysema subtypes were scored by radiologists. Results were adjusted for age, race/ethnicity, sex, height, weight, smoking status, pack-years, systemic hypertension and sleep apnea. Results RV end-diastolic volume was reduced in COPD compared to controls (-7.8 mL, 95% CI: -15.0, -0.5 mL; p=0.04). Increasing severity of COPD was associated with smaller RV end-diastolic volume (p=0.004) and lower RV stroke volume (p<0.001). RV mass and ejection fraction were similar between the groups. Greater percent emphysema was also associated with smaller RV end-diastolic volume (p=0.005) and stroke volume (p<0.001), as was the presence of centrilobular and paraseptal emphysema. Conclusions RV volumes are lower without significant alterations in RV mass and ejection fraction in contemporary COPD (“cor pulmonale parvus”) and this reduction is related to greater percent emphysema on computed tomography.

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“…Other covariables, including race/ethnicity, height, weight, presence of hypertension or diabetes mellitus, C‐reactive protein (CRP), smoking status, spirometry, and emphysema, were measured as described elsewhere (see appendix, available online) 24 …”

Section: Methodsmentioning

confidence: 99%

Pentraxin‐3 and the Right Ventricle: The Multi‐Ethnic Study of Atherosclerosis–Right Ventricle Study

et al. 2014

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BACKGROUND: Coarse particulate matter (PM 10-2:5) is primarily mechanically generated and includes crustal material, brake and tire wear, and biological particles. PM 10-2:5 is associated with pulmonary disease, which can lead to right ventricular (RV) dysfunction. Although RV characteristics have been associated with combustion-related pollutants, relationships with PM 10-2:5 remain unknown. OBJECTIVES: To quantify cross-sectional associations between RV dysfunction and PM 10-2:5 mass and components among older adults and susceptible populations. METHODS: We used baseline cardiac magnetic resonance images from 1,490 participants (45-84 y old) from the Multi-Ethnic Study of Atherosclerosis and assigned 5-y residential concentrations of PM 10-2:5 mass, copper, zinc, phosphorus, silicon, and endotoxin, using land-use regression models. We quantified associations with RV mass, end-diastolic volume, and ejection fraction after control for risk factors and copollutants using linear regression. We further examined personal susceptibility. RESULTS: We found positive associations of RV mass and, to a lesser extent, end diastolic volume with PM 10-2:5 mass among susceptible populations including smokers and persons with emphysema. After adjustment for copollutants, an interquartile range increase in PM 10-2:5 mass (2:2 lg=m 3) was associated with 0:5 g (95% CI: 0.0, 1.0), 0:9 g (95% CI: 0.1, 1.7), and 1:4 g (95% CI: 0.4, 2.5) larger RV mass among former smokers, current smokers , and persons with emphysema, respectively. No associations were found with healthy individuals or with ejection fraction. CONCLUSIONS: Alterations to RV structure may represent a mechanism by which long-term PM 10-2:5 exposure increases risks for adverse respiratory and cardiovascular outcomes, especially among certain susceptible populations. https://doi.

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Von Willebrand Factor and the Right Ventricle (the MESA-Right Ventricle Study)

Cited by 5 publications

References 30 publications

Association of Systemic Arterial Properties With Right Ventricular Morphology: The Multi‐Ethnic Study of Atherosclerosis (MESA)‐Right Ventricle Study

Association of Systemic Arterial Properties With Right Ventricular Morphology: The Multi‐Ethnic Study of Atherosclerosis (MESA)‐Right Ventricle Study

Cor Pulmonale Parvus in Chronic Obstructive Pulmonary Disease and Emphysema

Pentraxin‐3 and the Right Ventricle: The Multi‐Ethnic Study of Atherosclerosis–Right Ventricle Study

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