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

https://doi.org/10.1016/j.jacc.2006.03.072Get rights and content
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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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Supported by contracts N01-HC-95159 through N01-HC-95166 and N01-HC-95168 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. William S. Weintraub, MD, FACC, acted as guest editor for this article.