Association between reduced myocardial contraction fraction and cardiovascular disease outcomes: The Multi-Ethnic Study of Atherosclerosis

Marwah Abdalla, Elvis A. Akwo, David A. Bluemke, Joao Lima, Daichi Shimbo, Mathew S. Maurer, Alain G. Bertoni

Research output: Contribution to journalArticle

Abstract

Background: The myocardial contraction fraction (MCF: stroke volume to myocardial volume) is a volumetric measure of left ventricular myocardial shortening. We examined the relationship of MCF, measured by cardiac magnetic resonance imaging (cMRI), to incident cardiovascular (CV) events within the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Participants (n = 5000, aged 45–84 years) underwent cMRI. Primary outcome: CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease: CHD death, and stroke death). Secondary outcomes: CHD and heart failure (HF) events. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for outcomes. Results: There were 299 incident CVD, 188 CHD, and 151 HF events over 10.2 years. The lowest MCF quartile was associated with an increased risk for incident CVD [HR 2.42, CI: 1.58–3.72], CHD [HR 2.32, CI: 1.36–3.96] and HF events [HR 1.99, CI: 1.15–3.44]. In a model adjusted for demographics, CV risk factors, antihypertensive and lipid-lowering medication use, each standard deviation decrease in MCF was associated with incident CVD [HR 1.42, CI: 1.23–1.64], CHD [HR 1.40, CI: 1.17–1.67] and HF [HR 1.58, CI: 1.30–1.94]. In a subgroup analysis of participants with preserved ejection fraction and without left ventricular hypertrophy, the lowest MCF quartile and each standard deviation decrease in MCF was also associated with an increased risk for incident CVD in fully-adjusted analyses. Conclusions: MCF is a novel measure that can be measured using cMRI. In this multi-ethnic cohort, MCF is a measure that can be used to predict incident CVD events.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StatePublished - Jan 1 2019

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Myocardial Contraction
Atherosclerosis
Cardiovascular Diseases
Confidence Intervals
Heart Failure
Magnetic Resonance Imaging
Stroke
Left Ventricular Hypertrophy
Heart Arrest
Stroke Volume
Antihypertensive Agents
Coronary Disease
Myocardial Infarction
Demography
Lipids

Keywords

  • Cardiovascular disease
  • Epidemiology
  • Myocardial contraction fraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association between reduced myocardial contraction fraction and cardiovascular disease outcomes : The Multi-Ethnic Study of Atherosclerosis. / Abdalla, Marwah; Akwo, Elvis A.; Bluemke, David A.; Lima, Joao; Shimbo, Daichi; Maurer, Mathew S.; Bertoni, Alain G.

In: International Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Abdalla, Marwah ; Akwo, Elvis A. ; Bluemke, David A. ; Lima, Joao ; Shimbo, Daichi ; Maurer, Mathew S. ; Bertoni, Alain G. / Association between reduced myocardial contraction fraction and cardiovascular disease outcomes : The Multi-Ethnic Study of Atherosclerosis. In: International Journal of Cardiology. 2019.
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abstract = "Background: The myocardial contraction fraction (MCF: stroke volume to myocardial volume) is a volumetric measure of left ventricular myocardial shortening. We examined the relationship of MCF, measured by cardiac magnetic resonance imaging (cMRI), to incident cardiovascular (CV) events within the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Participants (n = 5000, aged 45–84 years) underwent cMRI. Primary outcome: CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease: CHD death, and stroke death). Secondary outcomes: CHD and heart failure (HF) events. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95{\%} confidence intervals (CI) for outcomes. Results: There were 299 incident CVD, 188 CHD, and 151 HF events over 10.2 years. The lowest MCF quartile was associated with an increased risk for incident CVD [HR 2.42, CI: 1.58–3.72], CHD [HR 2.32, CI: 1.36–3.96] and HF events [HR 1.99, CI: 1.15–3.44]. In a model adjusted for demographics, CV risk factors, antihypertensive and lipid-lowering medication use, each standard deviation decrease in MCF was associated with incident CVD [HR 1.42, CI: 1.23–1.64], CHD [HR 1.40, CI: 1.17–1.67] and HF [HR 1.58, CI: 1.30–1.94]. In a subgroup analysis of participants with preserved ejection fraction and without left ventricular hypertrophy, the lowest MCF quartile and each standard deviation decrease in MCF was also associated with an increased risk for incident CVD in fully-adjusted analyses. Conclusions: MCF is a novel measure that can be measured using cMRI. In this multi-ethnic cohort, MCF is a measure that can be used to predict incident CVD events.",
keywords = "Cardiovascular disease, Epidemiology, Myocardial contraction fraction",
author = "Marwah Abdalla and Akwo, {Elvis A.} and Bluemke, {David A.} and Joao Lima and Daichi Shimbo and Maurer, {Mathew S.} and Bertoni, {Alain G.}",
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T1 - Association between reduced myocardial contraction fraction and cardiovascular disease outcomes

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Abdalla, Marwah

AU - Akwo, Elvis A.

AU - Bluemke, David A.

AU - Lima, Joao

AU - Shimbo, Daichi

AU - Maurer, Mathew S.

AU - Bertoni, Alain G.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The myocardial contraction fraction (MCF: stroke volume to myocardial volume) is a volumetric measure of left ventricular myocardial shortening. We examined the relationship of MCF, measured by cardiac magnetic resonance imaging (cMRI), to incident cardiovascular (CV) events within the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Participants (n = 5000, aged 45–84 years) underwent cMRI. Primary outcome: CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease: CHD death, and stroke death). Secondary outcomes: CHD and heart failure (HF) events. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for outcomes. Results: There were 299 incident CVD, 188 CHD, and 151 HF events over 10.2 years. The lowest MCF quartile was associated with an increased risk for incident CVD [HR 2.42, CI: 1.58–3.72], CHD [HR 2.32, CI: 1.36–3.96] and HF events [HR 1.99, CI: 1.15–3.44]. In a model adjusted for demographics, CV risk factors, antihypertensive and lipid-lowering medication use, each standard deviation decrease in MCF was associated with incident CVD [HR 1.42, CI: 1.23–1.64], CHD [HR 1.40, CI: 1.17–1.67] and HF [HR 1.58, CI: 1.30–1.94]. In a subgroup analysis of participants with preserved ejection fraction and without left ventricular hypertrophy, the lowest MCF quartile and each standard deviation decrease in MCF was also associated with an increased risk for incident CVD in fully-adjusted analyses. Conclusions: MCF is a novel measure that can be measured using cMRI. In this multi-ethnic cohort, MCF is a measure that can be used to predict incident CVD events.

AB - Background: The myocardial contraction fraction (MCF: stroke volume to myocardial volume) is a volumetric measure of left ventricular myocardial shortening. We examined the relationship of MCF, measured by cardiac magnetic resonance imaging (cMRI), to incident cardiovascular (CV) events within the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Participants (n = 5000, aged 45–84 years) underwent cMRI. Primary outcome: CVD events (myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease: CHD death, and stroke death). Secondary outcomes: CHD and heart failure (HF) events. Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for outcomes. Results: There were 299 incident CVD, 188 CHD, and 151 HF events over 10.2 years. The lowest MCF quartile was associated with an increased risk for incident CVD [HR 2.42, CI: 1.58–3.72], CHD [HR 2.32, CI: 1.36–3.96] and HF events [HR 1.99, CI: 1.15–3.44]. In a model adjusted for demographics, CV risk factors, antihypertensive and lipid-lowering medication use, each standard deviation decrease in MCF was associated with incident CVD [HR 1.42, CI: 1.23–1.64], CHD [HR 1.40, CI: 1.17–1.67] and HF [HR 1.58, CI: 1.30–1.94]. In a subgroup analysis of participants with preserved ejection fraction and without left ventricular hypertrophy, the lowest MCF quartile and each standard deviation decrease in MCF was also associated with an increased risk for incident CVD in fully-adjusted analyses. Conclusions: MCF is a novel measure that can be measured using cMRI. In this multi-ethnic cohort, MCF is a measure that can be used to predict incident CVD events.

KW - Cardiovascular disease

KW - Epidemiology

KW - Myocardial contraction fraction

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