TY - JOUR
T1 - Association of CMR-measured la function with heart failure development
T2 - Results from the MESA study
AU - Habibi, Mohammadali
AU - Chahal, Harjit
AU - Opdahl, Anders
AU - Gjesdal, Ola
AU - Helle-Valle, Thomas M.
AU - Heckbert, Susan R.
AU - McClelland, Robyn
AU - Wu, Colin
AU - Shea, Steven
AU - Hundley, Gregory
AU - Bluemke, David A.
AU - Lima, João A.C.
N1 - Funding Information:
This research was supported by contracts N01-HC-95159 through N01-HC-95166 and N01-HC-95168 from the National Heart, Lung, and Blood Institute and UL1-RR-024156 and UL1-RR-025005 from the National Center for Research Resources , National Institutes of Health . All authors have reported that they have no relationships relevant to the contents of this paper to disclose. Sherif Nagueh, MD, served as Guest Editor for this paper.
PY - 2014/6
Y1 - 2014/6
N2 - OBJECTIVES: The goal of this study was to assess the association between left atrial (LA) volume and function measured with feature-tracking cardiac magnetic resonance (CMR) and development of heart failure (HF) in asymptomatic individuals. BACKGROUND: Whether alterations of LA structure and function precede or follow HF development remains incompletely understood. We hypothesized that significant alterations of LA deformation and architecture precede the development of HF in the general population. METHODS: In a case-control study nested in MESA (Multi-Ethnic Study of Atherosclerosis), baseline LA volume and function assessed using CMR feature-tracking were compared between 112 participants with incident HF (mean age 68.4 ± 8.2 years; 66% men) and 224 age- and sex-matched controls (mean age 67.7 ± 8.9 years; 66% men). Participants were followed up for 8 years. All individuals were in normal sinus rhythm at the time of imaging, without any significant valvular abnormalities and free of clinical cardiovascular diseases. RESULTS: Individuals with incident HF had greater maximal and minimal LA volume indexes (LAVImin) than control subjects (40 ± 13 mm3/m 2 vs. 33 ± 10 mm3/m2 [p <0.001] for maximal LA index and 25 ± 11 mm3/m2 vs. 17 ± 7 mm3/m2 [p <0.001] for LAVImin). The HF case subjects also had smaller global peak longitudinal atrial strain (PLAS) (25 ± 11% vs. 38 ± 16%; p <0.001) and lower LA emptying fraction (40 ± 11% vs. 48 ± 9%; p <0.001) at baseline. After adjustment for traditional cardiovascular risk factors, left ventricular mass, and N-terminal pro-B-type natriuretic peptide, global PLAS (odds ratio: 0.36 per SD [95% confidence interval: 0.22 to 0.60]) and LAVImin (odds ratio: 1.65 per SD [95% confidence interval: 1.04 to 2.63]) were independently associated with incident HF. CONCLUSIONS: Deteriorations in LA structure and function preceded development of HF. Lower global PLAS and higher LAVI min, measured using CMR feature-tracking, were independent markers of incident HF in a multiethnic population of asymptomatic individuals.
AB - OBJECTIVES: The goal of this study was to assess the association between left atrial (LA) volume and function measured with feature-tracking cardiac magnetic resonance (CMR) and development of heart failure (HF) in asymptomatic individuals. BACKGROUND: Whether alterations of LA structure and function precede or follow HF development remains incompletely understood. We hypothesized that significant alterations of LA deformation and architecture precede the development of HF in the general population. METHODS: In a case-control study nested in MESA (Multi-Ethnic Study of Atherosclerosis), baseline LA volume and function assessed using CMR feature-tracking were compared between 112 participants with incident HF (mean age 68.4 ± 8.2 years; 66% men) and 224 age- and sex-matched controls (mean age 67.7 ± 8.9 years; 66% men). Participants were followed up for 8 years. All individuals were in normal sinus rhythm at the time of imaging, without any significant valvular abnormalities and free of clinical cardiovascular diseases. RESULTS: Individuals with incident HF had greater maximal and minimal LA volume indexes (LAVImin) than control subjects (40 ± 13 mm3/m 2 vs. 33 ± 10 mm3/m2 [p <0.001] for maximal LA index and 25 ± 11 mm3/m2 vs. 17 ± 7 mm3/m2 [p <0.001] for LAVImin). The HF case subjects also had smaller global peak longitudinal atrial strain (PLAS) (25 ± 11% vs. 38 ± 16%; p <0.001) and lower LA emptying fraction (40 ± 11% vs. 48 ± 9%; p <0.001) at baseline. After adjustment for traditional cardiovascular risk factors, left ventricular mass, and N-terminal pro-B-type natriuretic peptide, global PLAS (odds ratio: 0.36 per SD [95% confidence interval: 0.22 to 0.60]) and LAVImin (odds ratio: 1.65 per SD [95% confidence interval: 1.04 to 2.63]) were independently associated with incident HF. CONCLUSIONS: Deteriorations in LA structure and function preceded development of HF. Lower global PLAS and higher LAVI min, measured using CMR feature-tracking, were independent markers of incident HF in a multiethnic population of asymptomatic individuals.
KW - feature-tracking MRI
KW - heart failure
KW - left atrial function
KW - left atrial strain
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U2 - 10.1016/j.jcmg.2014.01.016
DO - 10.1016/j.jcmg.2014.01.016
M3 - Article
C2 - 24813967
AN - SCOPUS:84902278539
SN - 1936-878X
VL - 7
SP - 570
EP - 579
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 6
ER -