This Article Full Text Full Text (PDF) All Versions of this Article: 112/7/984    most recent CIRCULATIONAHA.104.500488v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rosen, B. D. Articles by Lima, J. A.C. Search for Related Content PubMed PubMed Citation Articles by Rosen, B. D. Articles by Lima, J. A.C. Related Collections Contractile function Remodeling CT and MRI Related Article

(Circulation. 2005;112:984-991.)
© 2005 American Heart Association, Inc.

Imaging

Left Ventricular Concentric Remodeling Is Associated With Decreased Global and Regional Systolic Function

The Multi-Ethnic Study of Atherosclerosis

Boaz D. Rosen, MD; Thor Edvardsen, MD, PhD; Shenghan Lai, MD, PhD; Ernesto Castillo, MD; Li Pan, MS; Michael Jerosch-Herold, PhD; Shantanu Sinha, PhD; Richard Kronmal, PhD; Donna Arnett, PhD; John R. Crouse, III, MD; Susan R. Heckbert, MD; David A. Bluemke, MD, PhD; Joao A.C. Lima, MD

From the Cardiology Division of the Department of Medicine (B.D.R., T.E., J.A.C.L.) and Departments of Radiology (E.C., D.A.B.) and Biomedical Engineering (L.P.), Johns Hopkins Medical Institutions, Baltimore, Md; Department of Epidemiology, Bloomberg School of Public Health and Hygiene (S.L.), Johns Hopkins University, Baltimore, Md; University of Minnesota, Minneapolis (M.J.-H., D.A.); UCLA, Los Angeles, Calif (S.S.); Wake-Forest University School of Medicine, Winston-Salem, NC (J.R.C.); and University of Washington, Seattle (R.K., S.R.H.).

Correspondence to João A.C. Lima, MD, Cardiology Division, Blalock 569, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-6568. E-mail jlima{at}jhmi.edu

Received August 26, 2004; revision received April 8, 2005; accepted April 14, 2005.

Background— The transition from compensatory concentric remodeling to myocardial failure is not completely understood in humans. To investigate determinants of incipient myocardial dysfunction, we examined the association between concentric remodeling and regional LV function in asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods and Results— Myocardial tagged MRI was performed. Regional myocardial function expressed as peak systolic midwall circumferential strain (Ecc) was analyzed in 441 consecutive studies by HARP (Harmonic Phase) tool. Peak Ecc was correlated with the extent of concentric remodeling determined by the ratio of left ventricular mass to end-diastolic volume (M/V ratio). In men, a gradual decline in peak global Ecc was seen with increasing M/V ratio (test for trend, P<0.001). Among women, however, Ecc tended to be lower only in the fifth compared with the first quintile of M/V ratio (P=0.1). The association of lower Ecc with increasing M/V ratio was regionally heterogeneous but was particularly prominent in the LAD region in men (test for trend, P<0.001) and in women (test for trend, P=0.02). In the right coronary and left circumflex artery territories, these associations were less marked in both genders.

Conclusions— In this cross-sectional study of asymptomatic individuals, concentric left ventricular remodeling was related to decreased regional systolic function. The reduction in regional function, which was more pronounced in the left anterior descending coronary artery territory, may reflect the local transition from compensatory remodeling to myocardial dysfunction.

Key Words: hypertrophy • magnetic resonance imaging • remodeling • systole

Related Article:

The Transition From Hypertrophy to Failure: How Certain Are We?

Mark H. Drazner
Circulation 2005 112: 936-938. [Extract] [Full Text]

This article has been cited by other articles:

				N. S. Chahal, T. K. Lim, P. Jain, J. C. Chambers, J. S. Kooner, and R. Senior New insights into the relationship of left ventricular geometry and left ventricular mass with cardiac function: a population study of hypertensive subjects Eur. Heart J., November 19, 2009; (2009) ehp490v1. [Abstract] [Full Text] [PDF]

				B. D. Rosen, V. R.S. Fernandes, K. Nasir, T. Helle-Valle, M. Jerosch-Herold, D. A. Bluemke, and J. A.C. Lima Age, Increased Left Ventricular Mass, and Lower Regional Myocardial Perfusion Are Related to Greater Extent of Myocardial Dyssynchrony in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis Circulation, September 8, 2009; 120(10): 859 - 866. [Abstract] [Full Text] [PDF]

				E. Mousseaux Obesity and cardiovascular disease: how can cardiac magnetic resonance help? J. Am. Coll. Cardiol., August 18, 2009; 54(8): 727 - 729. [Full Text] [PDF]

				B. A. Borlaug, C. S.P. Lam, V. L. Roger, R. J. Rodeheffer, and M. M. Redfield Contractility and ventricular systolic stiffening in hypertensive heart disease insights into the pathogenesis of heart failure with preserved ejection fraction. J. Am. Coll. Cardiol., July 28, 2009; 54(5): 410 - 418. [Abstract] [Full Text] [PDF]

				S. Cheng, V. R.S. Fernandes, D. A. Bluemke, R. L. McClelland, R. A. Kronmal, and J. A.C. Lima Age-Related Left Ventricular Remodeling and Associated Risk for Cardiovascular Outcomes: The Multi-Ethnic Study of Atherosclerosis Circ Cardiovasc Imaging, May 1, 2009; 2(3): 191 - 198. [Abstract] [Full Text] [PDF]

				L. Iles, H. Pfluger, A. Phrommintikul, J. Cherayath, P. Aksit, S. N. Gupta, D. M. Kaye, and A. J. Taylor Evaluation of Diffuse Myocardial Fibrosis in Heart Failure With Cardiac Magnetic Resonance Contrast-Enhanced T1 Mapping J. Am. Coll. Cardiol., November 4, 2008; 52(19): 1574 - 1580. [Abstract] [Full Text] [PDF]

				R. Beeri, C. Yosefy, J. L. Guerrero, F. Nesta, S. Abedat, M. Chaput, F. del Monte, M. D. Handschumacher, R. Stroud, S. Sullivan, et al. Mitral regurgitation augments post-myocardial infarction remodeling failure of hypertrophic compensation. J. Am. Coll. Cardiol., January 29, 2008; 51(4): 476 - 486. [Abstract] [Full Text] [PDF]

				R. Q Osborn, W. C Taylor, K. Oken, M. Luzano, M. Heckman, and G. Fletcher Echocardiographic characterisation of left ventricular geometry of professional male tennis players Br. J. Sports Med., November 1, 2007; 41(11): 789 - 792. [Abstract] [Full Text] [PDF]

				W. J. Paulus, C. Tschope, J. E. Sanderson, C. Rusconi, F. A. Flachskampf, F. E. Rademakers, P. Marino, O. A. Smiseth, G. De Keulenaer, A. F. Leite-Moreira, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology Eur. Heart J., October 2, 2007; 28(20): 2539 - 2550. [Abstract] [Full Text] [PDF]

				J. Lumens, T. Delhaas, T. Arts, B. R. Cowan, and A. A. Young Impaired subendocardial contractile myofiber function in asymptomatic aged humans, as detected using MRI Am J Physiol Heart Circ Physiol, October 1, 2006; 291(4): H1573 - H1579. [Abstract] [Full Text] [PDF]

				B. D. Rosen, J. A.C. Lima, K. Nasir, T. Edvardsen, A. R. Folsom, S. Lai, D. A. Bluemke, and M. Jerosch-Herold Lower Myocardial Perfusion Reserve Is Associated With Decreased Regional Left Ventricular Function in Asymptomatic Participants of the Multi-Ethnic Study of Atherosclerosis Circulation, July 25, 2006; 114(4): 289 - 297. [Abstract] [Full Text] [PDF]

				V. R.S. Fernandes, J. F. Polak, T. Edvardsen, B. Carvalho, A. Gomes, D. A. Bluemke, K. Nasir, D. H. O'Leary, and J. A.C. Lima Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis (MESA) J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2420 - 2428. [Abstract] [Full Text] [PDF]

				M. H. Drazner The Transition From Hypertrophy to Failure: How Certain Are We? Circulation, August 16, 2005; 112(7): 936 - 938. [Full Text] [PDF]