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CLINICAL RESEARCH: CARDIAC IMAGING

Traditional Cardiovascular Risk Factors in Relation to Left Ventricular Mass, Volume, and Systolic Function by Cardiac Magnetic Resonance Imaging

The Multiethnic Study of Atherosclerosis

Susan R. Heckbert, MD, PhD^_*,_*, Wendy Post, MD, MS, FACC, Gregory D.N. Pearson, MD, PhD, Donna K. Arnett, PhD^||, Antoinette S. Gomes, MD^¶, Michael Jerosch-Herold, MD^#, W. Gregory Hundley, MD, FACC^_**, Joao A. Lima, MD, FACC and David A. Bluemke, MD, PhD

^_* Department of Epidemiology, University of Washington, Seattle, Washington
Department of Medicine, Johns Hopkins University, Baltimore, Maryland
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
Department of Radiology, Columbia University, New York, New York
^|| Department of Epidemiology, University of Alabama, Birmingham, Alabama
^¶ Department of Radiology, University of California, Los Angeles, California
^# Department of Radiology, University of Minnesota, Minneapolis, Minnesota
^_** Department of Medicine, Wake Forest University, Winston-Salem, North Carolina.

Manuscript received January 19, 2006; revised manuscript received March 20, 2006, accepted March 30, 2006.

^_* Reprint requests and correspondence: Dr. Susan R. Heckbert, University of Washington Cardiovascular Health Research Unit, 1730 Minor Avenue, Suite 1360, Seattle, Washington 98101-1448. (Email: heckbert{at}u.washington.edu).

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% CI –3.3 to –0.5 and –4.5 ml, 95% CI –6.0 to –3.0, respectively) and lower ejection fraction (–1.6%, 95% CI –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.

Abbreviations and Acronyms   CARDIA = Coronary Artery Risk Development in Young Adults   HDL = high-density lipoprotein   ICC = intraclass correlation coefficient   LDL = low-density lipoprotein   LV = left ventricular   MESA = Multiethnic Study of Atherosclerosis   MRI = magnetic resonance imaging

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