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Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured by Magnetic Resonance Imaging: The Multi-Ethnic Study of Atherosclerosis.

Abstract

BACKGROUND

This study sought to assess cross-sectional associations of aortic stiffness assessed by magnetic resonance imaging with left ventricular (LV) remodeling and myocardial deformation in the Multi-Ethnic Study of Atherosclerosis (MESA).

METHODS AND RESULTS

Aortic arch pulse wave velocity (PWV) was measured with phase contrast cine magnetic resonance imaging. LV circumferential strain (Ecc), torsion, and early diastolic strain rate were determined by tagged magnetic resonance imaging. Multivariable linear regression models were used to adjust for demographics and cardiovascular risk factors. Of 2093 participants, multivariable linear regression models demonstrated that higher arch PWV was associated with higher LV mass index (B=0.53 per 1 SD increase for log-transformed PWV, P<0.05) and LV mass to volume ratio (B=0.015, P<0.01), impaired LV ejection fraction (LVEF; B=-0.84; P<0.001), Ecc (B=0.55; P<0.001), torsion (B=-0.11; P<0.001), and early diastolic strain rate (B=-0.003; P<0.05). In sex stratified analysis, higher arch PWV was associated with higher MVR (B=0.02; P<0.05), impaired Ecc (B=0.60; P<0.001), and LVEF (B=-0.45; P<0.05), but with maintained torsion in women. Higher PWV was associated with impaired Ecc (B=0.49; P<0.001) and LVEF (B=-1.21; P<0.001), with lower torsion (B=-0.17; P<0.001) in men.

CONCLUSIONS

Higher arch PWV is associated with LV remodeling, and reduced LV systolic and diastolic function in a large multiethnic population. Greater aortic arch stiffness is associated with concentric LV remodeling and relatively preserved LVEF with maintained torsion in women, whereas greater aortic arch stiffness is associated with greater LV dysfunction demonstrated as impaired Ecc, torsion, and LVEF, with less concentric LV remodeling in men.

Authors+Show Affiliations

From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.).From the Department of Cardiology (Y.O., C.N., A.R.C., G.T.-T., J.-Y.K., S.D., K.Y., O.G., J.A.C.L.), Department of Radiology (B.A.-V.), Johns Hopkins University, Baltimore, MD; Department of Cardiology, Hospital General Universitari Vall d'Herbron, Barcelona, Spain (G.T.-T.); Department of Cardiology, Oslo University Hospital, Norway (O.G.); Imagerie Cardiovasculaire/Cardiovascular Imaging DICVRI, Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France (A.R.); National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD (C.-Y.L., D.A.B.); Clinical Investigation and Research Unit, Gunma University, Maebashi, Japan (T.N.); Office of Biostatistics Research, National Heart, Lung and Blood Institute, Bethesda, MD (C.O.W.); and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (W.G.H.). jlima@jhmi.edu.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

27353852

Citation

Ohyama, Yoshiaki, et al. "Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured By Magnetic Resonance Imaging: the Multi-Ethnic Study of Atherosclerosis." Circulation. Cardiovascular Imaging, vol. 9, no. 7, 2016.
Ohyama Y, Ambale-Venkatesh B, Noda C, et al. Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured by Magnetic Resonance Imaging: The Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging. 2016;9(7).
Ohyama, Y., Ambale-Venkatesh, B., Noda, C., Chugh, A. R., Teixido-Tura, G., Kim, J. Y., ... Lima, J. A. (2016). Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured by Magnetic Resonance Imaging: The Multi-Ethnic Study of Atherosclerosis. Circulation. Cardiovascular Imaging, 9(7), doi:10.1161/CIRCIMAGING.115.004426.
Ohyama Y, et al. Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured By Magnetic Resonance Imaging: the Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging. 2016;9(7) PubMed PMID: 27353852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of Aortic Stiffness With Left Ventricular Remodeling and Reduced Left Ventricular Function Measured by Magnetic Resonance Imaging: The Multi-Ethnic Study of Atherosclerosis. AU - Ohyama,Yoshiaki, AU - Ambale-Venkatesh,Bharath, AU - Noda,Chikara, AU - Chugh,Atul R, AU - Teixido-Tura,Gisela, AU - Kim,Jang-Young, AU - Donekal,Sirisha, AU - Yoneyama,Kihei, AU - Gjesdal,Ola, AU - Redheuil,Alban, AU - Liu,Chia-Ying, AU - Nakamura,Tetsuya, AU - Wu,Colin O, AU - Hundley,W Gregory, AU - Bluemke,David A, AU - Lima,Joao A C, PY - 2015/12/04/received PY - 2016/05/18/accepted PY - 2016/6/30/entrez PY - 2016/6/30/pubmed PY - 2017/5/10/medline KW - epidemiology KW - heart ventricles KW - magnetic resonance imaging KW - pulse wave analysis KW - vascular stiffness JF - Circulation. Cardiovascular imaging JO - Circ Cardiovasc Imaging VL - 9 IS - 7 N2 - BACKGROUND: This study sought to assess cross-sectional associations of aortic stiffness assessed by magnetic resonance imaging with left ventricular (LV) remodeling and myocardial deformation in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS AND RESULTS: Aortic arch pulse wave velocity (PWV) was measured with phase contrast cine magnetic resonance imaging. LV circumferential strain (Ecc), torsion, and early diastolic strain rate were determined by tagged magnetic resonance imaging. Multivariable linear regression models were used to adjust for demographics and cardiovascular risk factors. Of 2093 participants, multivariable linear regression models demonstrated that higher arch PWV was associated with higher LV mass index (B=0.53 per 1 SD increase for log-transformed PWV, P<0.05) and LV mass to volume ratio (B=0.015, P<0.01), impaired LV ejection fraction (LVEF; B=-0.84; P<0.001), Ecc (B=0.55; P<0.001), torsion (B=-0.11; P<0.001), and early diastolic strain rate (B=-0.003; P<0.05). In sex stratified analysis, higher arch PWV was associated with higher MVR (B=0.02; P<0.05), impaired Ecc (B=0.60; P<0.001), and LVEF (B=-0.45; P<0.05), but with maintained torsion in women. Higher PWV was associated with impaired Ecc (B=0.49; P<0.001) and LVEF (B=-1.21; P<0.001), with lower torsion (B=-0.17; P<0.001) in men. CONCLUSIONS: Higher arch PWV is associated with LV remodeling, and reduced LV systolic and diastolic function in a large multiethnic population. Greater aortic arch stiffness is associated with concentric LV remodeling and relatively preserved LVEF with maintained torsion in women, whereas greater aortic arch stiffness is associated with greater LV dysfunction demonstrated as impaired Ecc, torsion, and LVEF, with less concentric LV remodeling in men. SN - 1942-0080 UR - https://www.unboundmedicine.com/medline/citation/27353852/Association_of_Aortic_Stiffness_With_Left_Ventricular_Remodeling_and_Reduced_Left_Ventricular_Function_Measured_by_Magnetic_Resonance_Imaging:_The_Multi_Ethnic_Study_of_Atherosclerosis_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCIMAGING.115.004426?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -