Abstract 4330: Imaging Markers and Biomarkers of Subclinical Atherosclerosis Predict Changes in Regional and Global Left Ventricular Function as well as Incident Congestive Heart Failure in Asymptomatic Adults: The Multi-Ethnic Study of Atherosclerosis
Introduction: The relative contributions of different subclinical markers of atherosclerosis to progressive left ventricular (LV) dysfunction and CHF remain incompletely understood. We determined the associations of the two main imaging markers of subclinical atherosclerosis [common carotid maximal intima-media thickness (IMT) and coronary artery calcification (CAC)] and two representative biochemical markers of atherosclerosis (serum LDL cholesterol and IL-6) with progression of LV dysfunction and incident CHF in an asymptomatic population.
Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a multi-center cohort study of 6,814 participants (aged 45– 84 years, 3601 women) of four ethnicities: Whites, Blacks, Hispanics, and Chinese. All participants were followed for symptomatic CHF. MRI tagging was done in 1180 participants at baseline and repeated in 882 participants after 3–5 years of follow-up. In addition to regional circumferential strain (ECC) determined by HARP in three regions of myocardium (Table⇓ Footnote), LV ejection fraction (LVEF) derived from tagged MRI studies.
Results: Both carotid IMT and CAC were significant predictors of incident CHF (see Table⇓). However, after adjustment for established risk factors, neither carotid IMT nor CAC were associated with decline in global and regional LV function. In contrast to imaging markers of atherosclerosis, serum LDL cholesterol and serum IL-6 remained significant predictors of reduction in LV function even after adjustment for other risk factors (Table⇓).
Conclusions: Measures of subclinical atherosclerosis are predictors of regional LV functional decline and incident CHF. These associations are largely explained by established risk factors and inflammatory markers which appear to be independent of imaging markers of subclinical atherosclerosis. Overall, biomarkers closely related to atherosclerosis appear to be stronger predictors of change in LV function and incident CHF.