Abstract 14826: Association of Computed Tomography-Derived Left Ventricle Size With Major Cardiovascular Events in the General Population: The Heinz Nixdorf Recall Study
Background: Echocardiography data suggest a link of left ventricular (LV) size with CV morbidity and mortality. With the advent of cardiac CT, information on LV is readily available and may enhance the clinical value of this imaging modality.
Objective: To determine the association of CT-derived left ventricle index (LVI) with incident major cardiovascular (CV) events.
Methods: LV area was quantified from non-contrast CT in axial, end-diastolic images at a mid-ventricular slice in participants of the population-based Heinz Nixdorf Recall Study, free of cardiovascular disease. LVI was defined as the quotient of LV area and BSA. Major CV events (myocardial infarction, stroke, CV death) were assessed during follow up. Association of LVI with events was assessed using Cox-regression analysis in unadjusted models, adjusting for traditional CV risk factors and ancillary for coronary artery calcification (log(CAC+1)).
Results: Overall, 3926 subjects (59.2±7.7years, 53% female) were included in this analysis. Mean LVI was 2155±282mm2/m2 (range: 1268- 4005). During a follow-up period of 8.0±1.5 years, 219 subjects developed a major CV event. Those with events had significantly larger LVI at baseline (2258 vs. 2149mm2/m2, p<0.0001). In univariate analysis, increase of LVI by 1 standard deviation was associated with approximately 40% excess events (HR(95%CI): 1.41(1.26-1.59), p<0.0001). Associations remained statistically significant after adjustment for CV risk factors (1.24(1.10-1.40), p=0.0007) and were not affected when further adjusting for CAC (1.21(1.07-1.37), p=0.003). There was a trend towards stronger association for subjects with low CAC-score (CAC<100: 1.41(1.16-1.71), p=0.0005, CAC≥100: 1.24(1.06-1.44), p=0.006) in univariate analysis which persisted after multivariable adjustment (CAC<100: 1.38(1.12-1.71), p=0.003, CAC≥100: 1.14(0.97-1.34), p=0.11).
Conclusion: CT-derived LV size is associated with incident major CV events independent of traditional risk factors and CAC-score in an European population-based cohort and may improve the prediction of hard events especially in subjects with low CAC-scores. Our results encourage quantification of LV size from cardiac CT as it may complement information above CAC-scoring.
- © 2013 by American Heart Association, Inc.