Abstract 12226: Left Atrial Structure and Function and Cardiovascular Events in Patients With Diabetes Mellitus: Results From Multi-Ethnic Study of Atherosclerosis (MESA)
Introduction: Diabetes mellitus (DM) is associated with the development of cardiovascular disease (CVD). Morphological changes in the LA may appear before symptoms. We aimed to investigate the association between cardiac magnetic resonance imaging (CMR) measured LA structure and function and incident CVD in asymptomatic individuals with DM.
Methods: Tissue tracking CMR was used to measure LA size and phasic emptying fraction (EF) on all 574 MESA participants with DM and available baseline CMR, which was performed between 2000 and 2002. MESA is a population based, multi-center cohort study of 6814 healthy individuals. CVD was defined as MI, resuscitated cardiac arrest, angina, stroke, heart failure, atrial fibrillation, and any mortality secondary to CVD. Cox regression was used to assess the association of LA parameters with incident CVD adjusted for traditional risk factors, LV mass assessed by CMR, NT Pro-BNP and maximum LA volume. Adjusted Kaplan-Meier curves are based on 25th percentile cut-offs.
Results: After a mean follow up of 7 years, 96 individuals developed CVD (mean age 64, 53%male, 79% treated). Individuals with incident CVD (mean age 66 years, 66% male vs. mean age 4 years, 50% male) had larger maximum and minimum LA volume index (LAVI) (32±13 mm3/m2 vs. 27±10 mm3/m2; 20±10mm3/m2 vs. 14 ±6 mm3/m2), and lower total and active EF than those without CVD (42±11% vs. 48±9%; 29±11% vs. 32±11%). p<0.01 for all. In the final model, there was a significant association of minimum LAVI, LA total EF, and LA active EF with incident CVD.
Conclusions: CMR measured LA structure and function are predictive of CVD in a diabetic multi-ethnic population free of any symptomatic CVD at baseline.
Author Disclosures: T.M. Markman: None. M. Habibi: None. B. Ambale-Venkatesh: None. M. Zareian: None. C. Wu: None. S.R. Heckbert: None. D.A. Bluemke: Other Research Support; Modest; Siemens Medical Systems, Philips Medical Systems. J.A. Lima: Research Grant; Significant; Toshiba Medical Systems.
- © 2014 by American Heart Association, Inc.