Association of myocardial fibrosis and cardiovascular events: the multi-ethnic study of atherosclerosis

Bharath Ambale Venkatesh, Chia Ying Liu, Yuan Chang Liu, Sirisha Donekal, Yoshiaki Ohyama, Ravi K. Sharma, Colin O. Wu, Wendy S Post, Gregory W. Hundley, David A. Bluemke, Joao Lima

Research output: Contribution to journalArticle

Abstract

Aims: We used contrast-enhanced cardiac magnetic resonance (CMR) to evaluate differences in myocardial fibrosis measured at the year-10 examination between participants with and without cardiovascular (CV) events accrued in a large population based study over the preceding 10-year follow-up period in this retrospective study. Methods and results: The MESA study enrolled 6814 participants free of CV disease at baseline (2000-2002). We included MESA participants who underwent contrast-enhanced CMR at the MESA year-10 exam (N = 1840). We defined a composite CV endpoint of coronary heart disease, heart failure, atrial fibrillation, stroke, and peripheral artery disease. Using CMR, we characterized myocardial fibrosis with late-gadolinium enhancement for scar and T1 mapping indices of diffuse fibrosis. Demographic and CV-risk adjusted logistic (presence of scar) and linear regression (pre-contrast T1, T1 at 12 and 25 min post-contrast, and extracellular volume fraction or ECV) models were used to assess the relationship between fibrosis and events. The mean values of T1 indices were-pre-contrast T1: 977 ± 45 ms; T1 at 12': 456 ± 40 ms; T1 at 25': 519 ± 41 ms; ECV: 27.1 ± 3.2%. One-hundred and forty-six (7.9%) participants had myocardial scar. The presence of scar was strongly associated with prior CV events (adjusted coeff: 1.36, P < 0.001). Lower post-contrast T1 times and higher ECV, indicative of greater diffuse fibrosis were strongly associated with CV events (T1 at 12': coeff = -10.0 ms, P = 0.004; T1 at 25': coeff =-9.2 ms, P = 0.008; ECV: coeff = 1.31%, P < 0.001). Conclusion: Individuals who suffered prior CV events have greater likelihood of diffuse myocardial fibrosis when compared with event-free individuals living in the same community.

Original languageEnglish (US)
Pages (from-to)168-176
Number of pages9
JournalEuropean Heart Journal Cardiovascular Imaging
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2019

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Atherosclerosis
Fibrosis
Cicatrix
Magnetic Resonance Spectroscopy
Peripheral Arterial Disease
Gadolinium
Atrial Fibrillation
Coronary Disease
Linear Models
Cardiovascular Diseases
Heart Failure
Retrospective Studies
Stroke
Demography
Population

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Association of myocardial fibrosis and cardiovascular events : the multi-ethnic study of atherosclerosis. / Ambale Venkatesh, Bharath; Liu, Chia Ying; Liu, Yuan Chang; Donekal, Sirisha; Ohyama, Yoshiaki; Sharma, Ravi K.; Wu, Colin O.; Post, Wendy S; Hundley, Gregory W.; Bluemke, David A.; Lima, Joao.

In: European Heart Journal Cardiovascular Imaging, Vol. 20, No. 2, 01.02.2019, p. 168-176.

Research output: Contribution to journalArticle

Ambale Venkatesh, Bharath ; Liu, Chia Ying ; Liu, Yuan Chang ; Donekal, Sirisha ; Ohyama, Yoshiaki ; Sharma, Ravi K. ; Wu, Colin O. ; Post, Wendy S ; Hundley, Gregory W. ; Bluemke, David A. ; Lima, Joao. / Association of myocardial fibrosis and cardiovascular events : the multi-ethnic study of atherosclerosis. In: European Heart Journal Cardiovascular Imaging. 2019 ; Vol. 20, No. 2. pp. 168-176.
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abstract = "Aims: We used contrast-enhanced cardiac magnetic resonance (CMR) to evaluate differences in myocardial fibrosis measured at the year-10 examination between participants with and without cardiovascular (CV) events accrued in a large population based study over the preceding 10-year follow-up period in this retrospective study. Methods and results: The MESA study enrolled 6814 participants free of CV disease at baseline (2000-2002). We included MESA participants who underwent contrast-enhanced CMR at the MESA year-10 exam (N = 1840). We defined a composite CV endpoint of coronary heart disease, heart failure, atrial fibrillation, stroke, and peripheral artery disease. Using CMR, we characterized myocardial fibrosis with late-gadolinium enhancement for scar and T1 mapping indices of diffuse fibrosis. Demographic and CV-risk adjusted logistic (presence of scar) and linear regression (pre-contrast T1, T1 at 12 and 25 min post-contrast, and extracellular volume fraction or ECV) models were used to assess the relationship between fibrosis and events. The mean values of T1 indices were-pre-contrast T1: 977 ± 45 ms; T1 at 12': 456 ± 40 ms; T1 at 25': 519 ± 41 ms; ECV: 27.1 ± 3.2{\%}. One-hundred and forty-six (7.9{\%}) participants had myocardial scar. The presence of scar was strongly associated with prior CV events (adjusted coeff: 1.36, P < 0.001). Lower post-contrast T1 times and higher ECV, indicative of greater diffuse fibrosis were strongly associated with CV events (T1 at 12': coeff = -10.0 ms, P = 0.004; T1 at 25': coeff =-9.2 ms, P = 0.008; ECV: coeff = 1.31{\%}, P < 0.001). Conclusion: Individuals who suffered prior CV events have greater likelihood of diffuse myocardial fibrosis when compared with event-free individuals living in the same community.",
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T2 - the multi-ethnic study of atherosclerosis

AU - Ambale Venkatesh, Bharath

AU - Liu, Chia Ying

AU - Liu, Yuan Chang

AU - Donekal, Sirisha

AU - Ohyama, Yoshiaki

AU - Sharma, Ravi K.

AU - Wu, Colin O.

AU - Post, Wendy S

AU - Hundley, Gregory W.

AU - Bluemke, David A.

AU - Lima, Joao

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N2 - Aims: We used contrast-enhanced cardiac magnetic resonance (CMR) to evaluate differences in myocardial fibrosis measured at the year-10 examination between participants with and without cardiovascular (CV) events accrued in a large population based study over the preceding 10-year follow-up period in this retrospective study. Methods and results: The MESA study enrolled 6814 participants free of CV disease at baseline (2000-2002). We included MESA participants who underwent contrast-enhanced CMR at the MESA year-10 exam (N = 1840). We defined a composite CV endpoint of coronary heart disease, heart failure, atrial fibrillation, stroke, and peripheral artery disease. Using CMR, we characterized myocardial fibrosis with late-gadolinium enhancement for scar and T1 mapping indices of diffuse fibrosis. Demographic and CV-risk adjusted logistic (presence of scar) and linear regression (pre-contrast T1, T1 at 12 and 25 min post-contrast, and extracellular volume fraction or ECV) models were used to assess the relationship between fibrosis and events. The mean values of T1 indices were-pre-contrast T1: 977 ± 45 ms; T1 at 12': 456 ± 40 ms; T1 at 25': 519 ± 41 ms; ECV: 27.1 ± 3.2%. One-hundred and forty-six (7.9%) participants had myocardial scar. The presence of scar was strongly associated with prior CV events (adjusted coeff: 1.36, P < 0.001). Lower post-contrast T1 times and higher ECV, indicative of greater diffuse fibrosis were strongly associated with CV events (T1 at 12': coeff = -10.0 ms, P = 0.004; T1 at 25': coeff =-9.2 ms, P = 0.008; ECV: coeff = 1.31%, P < 0.001). Conclusion: Individuals who suffered prior CV events have greater likelihood of diffuse myocardial fibrosis when compared with event-free individuals living in the same community.

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