Association of Longitudinal Changes in Left Ventricular Structure and Function with Myocardial Fibrosis: The MESA study RR
The association of longitudinal changes in LV structure and function with myocardial fibrosis is unclear. We relate temporal changes in body-size indexed LV mass (LVMi) and end-diastolic volume (EDVi), LV mass-to-volume ratio (MVR) and ejection fraction (LVEF) from cine CMR over 10 years, with repla...
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| Main Authors: | , , , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | Inglês |
| Publicado em: |
2014
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| Assuntos: | |
| Acesso em linha: | https://ncbi.nlm.nih.gov/pmc/articles/PMC4134415/ https://ncbi.nlm.nih.gov/pubmed/24914198 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1161/HYPERTENSIONAHA.114.03697 |
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| Sumario: | The association of longitudinal changes in LV structure and function with myocardial fibrosis is unclear. We relate temporal changes in body-size indexed LV mass (LVMi) and end-diastolic volume (EDVi), LV mass-to-volume ratio (MVR) and ejection fraction (LVEF) from cine CMR over 10 years, with replacement scar assessed from late-gadolinium enhancement, and lower post-contrast T1 times reflecting greater diffuse myocardial fibrosis measured at the end of the follow-up period. All participants (n=1813) who underwent CMR twice as part of the Multi-Ethnic Study of Atherosclerosis 10 years apart were included. Multivariable logistic and linear regression models adjusted for cardiovascular risk factors measured the association of 10-year changes in LV structure and function, with fibrosis measured at follow-up. The presence of LV scar at year-10 was cross-sectionally associated with higher LVMi (~10g/m2), higher MVR (0.1 – 0.2g/ml) but lower LVEF (~4%); and longitudinally with 3% decrease in LVEF and 0.7% greater EDVi in men over 10 years. Lower post-contrast T1 times at year-10 were associated cross-sectionally with lower LVMi (r=0.33), EDVi (r=0.25), and LVEF (in men only: r=0.14); and longitudinally with a decrease in LVMi (r=0.20) and reduction in LVEF (in men only: r=0.15). Sustained hypertension over 10 years was associated with increased LVMi, and higher diffuse and replacement fibrosis at follow-up. Over a 10-year period increased concentric hypertrophy in women and LV dilatation in men was associated with replacement fibrosis; while decreasing LVMi was associated with diffuse fibrosis. Hypertension induced remodeling was related to enhanced replacement and diffuse fibrosis as well as hypertrophy. |
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