TY - JOUR
T1 - A High Ankle Brachial Index Is Associated With Greater Left Ventricular Mass. MESA (Multi-Ethnic Study of Atherosclerosis)
AU - Ix, Joachim H.
AU - Katz, Ronit
AU - Peralta, Carmen A.
AU - de Boer, Ian H.
AU - Allison, Matthew A.
AU - Bluemke, David A.
AU - Siscovick, David S.
AU - Lima, João A.C.
AU - Criqui, Michael H.
PY - 2010/1/26
Y1 - 2010/1/26
N2 - Objectives: This study sought to determine the association of high ankle brachial index (ABI) measurements with left ventricular (LV) mass, and to compare its strength with that of low ABI with LV mass. Background: Arterial stiffness leads to LV mass through nonatherosclerotic pathways in mice. In humans, a high ABI indicates stiff peripheral arteries and is associated with cardiovascular disease (CVD) events. Whether high ABI is associated with LV mass in humans and whether this might reflect consequences of arterial stiffness, atherosclerosis, or both is unknown. Methods: Among 4,972 MESA (Multi-Ethnic Study of Atherosclerosis) participants without clinical CVD, we used linear regression to evaluate the association of low (<0.90) and high (>1.40 or incompressible) ABI with LV mass by cardiac magnetic resonance imaging (MRI). Intermediate ABIs served as the reference category. To determine the effect of subclinical atherosclerosis, models were adjusted for common and internal carotid intima media thickness (cIMT) and natural log-transformed coronary artery calcification. Results: Compared with subjects with intermediate ABI, LV mass was higher with either low (2.70 g/m2 higher, 95% confidence interval: 0.65 to 4.75) or high ABI (6.84 g/m2 higher, 95% confidence interval: 3.2 to 10.47) after adjustment for traditional CVD risk factors, kidney function, and C-reactive protein. However, further adjustment for cIMT and CAC substantially attenuated the association of low ABI with LV mass index (1.24 g/m2 higher, 95% confidence interval: -0.84 to 3.33), whereas the association of high ABI was minimally altered (6.01 g/m2 higher, 95% confidence interval: 2.36 to 9.67). Conclusions: High ABI is associated with greater LV mass; an association that is not attenuated with adjustment for subclinical atherosclerosis in nonperipheral arterial beds. High ABI might lead to greater LV mass through nonatherosclerotic pathways.
AB - Objectives: This study sought to determine the association of high ankle brachial index (ABI) measurements with left ventricular (LV) mass, and to compare its strength with that of low ABI with LV mass. Background: Arterial stiffness leads to LV mass through nonatherosclerotic pathways in mice. In humans, a high ABI indicates stiff peripheral arteries and is associated with cardiovascular disease (CVD) events. Whether high ABI is associated with LV mass in humans and whether this might reflect consequences of arterial stiffness, atherosclerosis, or both is unknown. Methods: Among 4,972 MESA (Multi-Ethnic Study of Atherosclerosis) participants without clinical CVD, we used linear regression to evaluate the association of low (<0.90) and high (>1.40 or incompressible) ABI with LV mass by cardiac magnetic resonance imaging (MRI). Intermediate ABIs served as the reference category. To determine the effect of subclinical atherosclerosis, models were adjusted for common and internal carotid intima media thickness (cIMT) and natural log-transformed coronary artery calcification. Results: Compared with subjects with intermediate ABI, LV mass was higher with either low (2.70 g/m2 higher, 95% confidence interval: 0.65 to 4.75) or high ABI (6.84 g/m2 higher, 95% confidence interval: 3.2 to 10.47) after adjustment for traditional CVD risk factors, kidney function, and C-reactive protein. However, further adjustment for cIMT and CAC substantially attenuated the association of low ABI with LV mass index (1.24 g/m2 higher, 95% confidence interval: -0.84 to 3.33), whereas the association of high ABI was minimally altered (6.01 g/m2 higher, 95% confidence interval: 2.36 to 9.67). Conclusions: High ABI is associated with greater LV mass; an association that is not attenuated with adjustment for subclinical atherosclerosis in nonperipheral arterial beds. High ABI might lead to greater LV mass through nonatherosclerotic pathways.
KW - cardiovascular disease
KW - heart failure
KW - left ventricular mass
KW - medial arterial calcification
KW - vascular stiffness
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U2 - 10.1016/j.jacc.2009.11.010
DO - 10.1016/j.jacc.2009.11.010
M3 - Article
C2 - 20117440
AN - SCOPUS:74049156317
VL - 55
SP - 342
EP - 349
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 4
ER -