Abstract 703: Aortic Atherosclerosis and Left Ventricular Structure in the Community
Background: Increasing aortic atherosclerosis predicts incident heart failure. We hypothesized that this relationship may be mediated by associated changes in left ventricular (LV) anatomy.
Methods: In 1009 attendees (mean age 60 years; 54% women) of Framingham Offspring Cohort examination cycle 7 who underwent multidetector CT (MDCT) and cardiac MRI (CMR), we related MDCT aortic atherosclerosis measures (thoracic aortic [TAC] and abdominal aortic [AAC] calcium) to CMR measures of LV mass (LVM), LV wall thickness (LVWT), LV end-diastolic volume (LVEDV) and LVM to LVEDV ratio (LVM/LVEDV). We conducted age- and sex-adjusted models, and multivariable-adjusted (MV) models adjusting for age, sex, BMI, systolic blood pressure, hypertension therapy, diabetes, total/HDL cholesterol, lipid-modifying therapy, smoking and estimated GFR.
Results: There was a continuous increase in LVM/LVEDV with increasing TAC and AAC in age- and sex-adjusted models, and with MV models (Table⇓). LVM increased with increasing AAC in age- and sex-adjusted models only (Table⇓). LVEDV decreased with increasing TAC in MV models (Table⇓). After additional adjustment for pulse pressure the association of TAC and AAC with LVM/LVEDV remained significant (β-coefficient 0.021 [p-value=0.0004] and 0.014 [p-value=0.02] respectively).
Conclusion: Increased aortic atherosclerosis detected as vascular calcium is associated with increased LV concentricity. Further studies are warranted to assess whether the propensity for concentric LV remodeling may be related to vascular stiffness due to increasing atherosclerosis.