Association of subclinical atherosclerosis using carotid intima-media thickness, carotid plaque, and coronary calcium score with left ventricular dyssynchrony: The multi-ethnic Study of Atherosclerosis

Ravi K. Sharma, Sirisha Donekal, Boaz D. Rosen, Matthew C. Tattersall, Gustavo J. Volpe, Bharath Ambale-Venkatesh, Khurram Nasir, Colin O. Wu, Joseph F. Polak, Claudia E. Korcarz, James H. Stein, James Carr, Karol E. Watson, David A. Bluemke, João A.C. Lima

Research output: Contribution to journalArticle

Abstract

Background: The role of atherosclerosis in the progression of global left ventricular dysfunction and cardiovascular events has been well recognized. Left ventricular (LV) dyssynchrony is a measure of regional myocardial dysfunction. Our objective was to investigate the relationship of subclinical atherosclerosis with mechanical LV dyssynchrony in a population-based asymptomatic multi-ethnic cohort. Methods and Results: Participants of the Multi-Ethnic Study of Atherosclerosis (MESA) at exam 5 were evaluated using 1.5T cardiac magnetic resonance (CMR) imaging, carotid ultrasound (n=2062) for common carotid artery (CCA) and internal carotid artery (ICA) intima-media thickness (IMT), and cardiac computed tomography (n=2039) for coronary artery calcium (CAC) assessment (Agatston method). Dyssynchrony indices were defined as the standard deviation of time to peak systolic circumferential strain (SD-TPS) and the difference between maximum and minimum (max-min) time to peak strain using harmonic phase imaging in 12 segments (3-slices×4 segments). Multivariable regression analyses were performed to assess associations after adjusting for participant demographics, cardiovascular risk factors, LV mass, and ejection fraction. In multivariable analyses, SD-TPS was significantly related to measures of atherosclerosis, including CCA-IMT (8.7ms/mm change in IMT, p=0.020), ICA-IMT (19.2ms/mm change in IMT, p<0.001), carotid plaque score (1.2 ms/unit change in score, p<0.001), and log transformed CAC+1 (0.66 ms/unit log-CAC+1, p=0.018). These findings were consistent with other parameter of LV dyssynchrony i.e. max-min. Conclusion: In the MESA cohort, measures of atherosclerosis are associated with parameters of subclinical LV dyssynchrony in the absence of clinical coronary event and left-bundle-branch block.

Original languageEnglish (US)
Pages (from-to)412-418
Number of pages7
JournalAtherosclerosis
Volume239
Issue number2
DOIs
StatePublished - Apr 1 2015

Keywords

  • Atherosclerosis
  • CAC
  • CCA
  • CMR
  • CT
  • Carotid IMT
  • Coronary calcium score
  • EGFR
  • HDL
  • HF
  • ICA
  • IMT
  • LBBB
  • LV
  • Left ventricular dyssynchrony
  • Max-min
  • SD
  • SD-TPS

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Sharma, R. K., Donekal, S., Rosen, B. D., Tattersall, M. C., Volpe, G. J., Ambale-Venkatesh, B., Nasir, K., Wu, C. O., Polak, J. F., Korcarz, C. E., Stein, J. H., Carr, J., Watson, K. E., Bluemke, D. A., & Lima, J. A. C. (2015). Association of subclinical atherosclerosis using carotid intima-media thickness, carotid plaque, and coronary calcium score with left ventricular dyssynchrony: The multi-ethnic Study of Atherosclerosis. Atherosclerosis, 239(2), 412-418. https://doi.org/10.1016/j.atherosclerosis.2015.01.041