Abstract 11292: Prevalence and Determinants of Myocardial Scar by Late Gadolinium Enhancement CMR: The Multi-Ethnic Study of Atherosclerosis

Abstract

BACKGROUND: The prevalence and determinants of myocardial scar by late gadolinium enhancement (LGE) CMR in a large multi-ethnic population have not previously been studied. Thus, we sought to describe determinants of myocardial scar in the Multi-Ethnic Study of Atherosclerosis (MESA).

METHODS: All participants were free of cardiovascular disease at the baseline exam (2000-2002). Traditional risk factors, carotid intimal-medial thickness (IMT), coronary artery calcium score (CS) and CMR for LV mass and volumes were measured at baseline exam. 1,862 subjects underwent LGE-CMR as part of a 10 year follow up exam (2010-2012). Participants with eGFR<45 were excluded. The associations of risk factors and imaging measures with myocardial scar were assessed with logistic regression models.

RESULTS: The prevalence of myocardial scar was 7.4% by LGE-CMR. Age, male gender, systolic blood pressure, diabetes, lower HDL, LV volume and mass, ascending aorta diameter, IMT and CS were determinants of myocardial scar. Chinese/ Hispanic ethnicities were less likely to have myocardial scar compared to Caucasians. In the multivariable model, age [Odds ratio (O.R.) 1.58 per 10 years] and male gender (O.R. 6.1) were associated with myocardial scar (p<0.001). With the addition of imaging variables to the model, male gender, LV mass/volume ratio (O.R. 1.36 per S.D.), and CS [O.R. 1.59 per S.D] were significantly associated with the presence of myocardial scar (Table).

CONCLUSIONS: In a large multi-center cohort, the prevalence of myocardial scar was 7.4%. Age, male gender, adverse myocardial remodeling and coronary calcium score were associated with myocardial scar as identified by CMR.