Abstract 14906: Left Ventricular Structure and Risk for Cardiovascular Disease Events: A Cardiac Magnetic Resonance Study
Introduction: Elevated left ventricular (LV) mass (LVM) is related to adverse cardiovascular disease (CVD) events. We sought to determine the association of volumetric-derived LV geometry to CVD events in a community sample without prevalent CVD.
Methods: Framingham Heart Study (FHS) Offspring Cohort members free of prevalent CVD (n=1662, 50% men, aged 65±9 years) underwent 1.5T cardiovascular magnetic resonance (CMR) to assess LV geometry and mass in 2002-2006 and were prospectively followed for incident hard CVD events (myocardial infarction, coronary insufficiency, heart failure, stroke, or CVD death). Age- and sex- and separate multivariable-adjusted Cox-proportional hazards regression models were fitted to evaluate the relations of LVM/LV end-diastolic volume (LVM/LVEDV), relative wall thickness (RWT), and LVM indexed to body surface area (LVMI) and separately to height2.7 to the composite outcome.
Results: In 6.5±1.4 years (up to 8.6 years) of follow-up, 60 incident CVD events occurred. Greater concentric geometry measured by LVM/LVEDV and RWT, as well as LVMI, all analyzed as continuous traits, were associated with elevated hazards for CVD events in all Cox models (TABLE ). After adjustment for CVD risk factors beyond age and sex, there was minimal attenuation of the hazard ratios for the composite outcome, suggesting that the ability of LV geometry and LVMI to predict hard CVD remains independent of these traditional CVD risk factors. Results were qualitatively unchanged when LVM was indexed to height2.7 alone.
Conclusions: Among asymptomatic adults in the community, greater LV concentric hypertrophy and mass index are associated with adverse incident CVD events. The potential benefit of identifying these individuals using volumetric CMR methods for aggressive primary prevention requires further investigation.
- © 2013 by American Heart Association, Inc.