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Left ventricular dilation and incident congestive heart failure in asymptomatic adults without cardiovascular disease: multi-ethnic study of atherosclerosis (MESA).
J Card Fail. 2014 Dec; 20(12):905-11.JC

Abstract

BACKGROUND

Limited data exist on the association between left ventricular (LV) dilation/remodeling and incident heart failure (HF), especially in adults without prior myocardial infarction (MI) and valvular heart disease. We assessed the association between LV dilation and remodeling and incident HF in a multiethnic cohort.

METHODS AND RESULTS

A total of 4,974 of 6,814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) had cardiac magnetic resonance imaging and complete data. Kaplan-Meier and Cox proportional hazard analyses were used to assess the association between LV end-diastolic diameter (LVEDD) and adjudicated HF. During the 12 years of follow-up (mean 9.4 y), 177 (3.6%) HF events occurred, 126 (71.2%) in HF with reduced ejection fraction (EF) and 51 (28.8%) in HF with preserved EF. LV dilation (LVEDD >52 mm or >95th percentile) was associated with HF in univariate (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.08-1.46; P = .007) and multivariable Cox models (HR 1.28, 95% CI 1.09-1.57; P = .01) adjusting for traditional risk factors, medication use, LV EF, and interim MI. We found a significant multiplicative interaction between LVEDD and LV EF in our full multivariable models. Participants with dilated LV and preserved EF had increased risk [HR 2.22, 95% CI 1.46-3.37; P = .006) and those with dilated LV and reduced EF had worse prognosis (HR 7.35, 95% CI 2.36-22.85; P = .0006) compared with normal-size LV and preserved EF. A high proportion of participants with LV dilation had eccentric remodeling, a risk factor for HF. Concentric hypertrophy, also a risk factor for HF, was common in the normal-size LV group.

CONCLUSIONS

LV dilation predicts incident HF independently from risk factors, LV EF, and interim MI.

Authors+Show Affiliations

Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina. Electronic address: jyeboah@wakehealth.edu.National Institutes of Health Clinical Center, Bethesda, Maryland.Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.Cardiology and Radiology, Johns Hopkins University, Baltimore, Maryland.Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25225112

Citation

Yeboah, Joseph, et al. "Left Ventricular Dilation and Incident Congestive Heart Failure in Asymptomatic Adults Without Cardiovascular Disease: Multi-ethnic Study of Atherosclerosis (MESA)." Journal of Cardiac Failure, vol. 20, no. 12, 2014, pp. 905-11.
Yeboah J, Bluemke DA, Hundley WG, et al. Left ventricular dilation and incident congestive heart failure in asymptomatic adults without cardiovascular disease: multi-ethnic study of atherosclerosis (MESA). J Card Fail. 2014;20(12):905-11.
Yeboah, J., Bluemke, D. A., Hundley, W. G., Rodriguez, C. J., Lima, J. A., & Herrington, D. M. (2014). Left ventricular dilation and incident congestive heart failure in asymptomatic adults without cardiovascular disease: multi-ethnic study of atherosclerosis (MESA). Journal of Cardiac Failure, 20(12), 905-11. https://doi.org/10.1016/j.cardfail.2014.09.002
Yeboah J, et al. Left Ventricular Dilation and Incident Congestive Heart Failure in Asymptomatic Adults Without Cardiovascular Disease: Multi-ethnic Study of Atherosclerosis (MESA). J Card Fail. 2014;20(12):905-11. PubMed PMID: 25225112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular dilation and incident congestive heart failure in asymptomatic adults without cardiovascular disease: multi-ethnic study of atherosclerosis (MESA). AU - Yeboah,Joseph, AU - Bluemke,David A, AU - Hundley,W Gregory, AU - Rodriguez,Carlos J, AU - Lima,Joao A C, AU - Herrington,David M, Y1 - 2014/09/16/ PY - 2014/07/15/received PY - 2014/08/22/revised PY - 2014/09/05/accepted PY - 2014/9/17/entrez PY - 2014/9/17/pubmed PY - 2015/7/24/medline KW - Left ventricular dilation KW - heart failure KW - left ventricular ejection fraction KW - left ventricular remodeling KW - risk factors SP - 905 EP - 11 JF - Journal of cardiac failure JO - J Card Fail VL - 20 IS - 12 N2 - BACKGROUND: Limited data exist on the association between left ventricular (LV) dilation/remodeling and incident heart failure (HF), especially in adults without prior myocardial infarction (MI) and valvular heart disease. We assessed the association between LV dilation and remodeling and incident HF in a multiethnic cohort. METHODS AND RESULTS: A total of 4,974 of 6,814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) had cardiac magnetic resonance imaging and complete data. Kaplan-Meier and Cox proportional hazard analyses were used to assess the association between LV end-diastolic diameter (LVEDD) and adjudicated HF. During the 12 years of follow-up (mean 9.4 y), 177 (3.6%) HF events occurred, 126 (71.2%) in HF with reduced ejection fraction (EF) and 51 (28.8%) in HF with preserved EF. LV dilation (LVEDD >52 mm or >95th percentile) was associated with HF in univariate (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.08-1.46; P = .007) and multivariable Cox models (HR 1.28, 95% CI 1.09-1.57; P = .01) adjusting for traditional risk factors, medication use, LV EF, and interim MI. We found a significant multiplicative interaction between LVEDD and LV EF in our full multivariable models. Participants with dilated LV and preserved EF had increased risk [HR 2.22, 95% CI 1.46-3.37; P = .006) and those with dilated LV and reduced EF had worse prognosis (HR 7.35, 95% CI 2.36-22.85; P = .0006) compared with normal-size LV and preserved EF. A high proportion of participants with LV dilation had eccentric remodeling, a risk factor for HF. Concentric hypertrophy, also a risk factor for HF, was common in the normal-size LV group. CONCLUSIONS: LV dilation predicts incident HF independently from risk factors, LV EF, and interim MI. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/25225112/Left_ventricular_dilation_and_incident_congestive_heart_failure_in_asymptomatic_adults_without_cardiovascular_disease:_multi_ethnic_study_of_atherosclerosis__MESA__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(14)01197-X DB - PRIME DP - Unbound Medicine ER -