TY - JOUR
T1 - Fibrinogen and left ventricular myocardial systolic function
T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)
AU - Yan, Raymond T.
AU - Fernandes, Veronica
AU - Yan, Andrew T.
AU - Cushman, Mary
AU - Redheuil, Alban
AU - Tracy, Russell
AU - Vogel-Claussen, Jens
AU - Bahrami, Hossein
AU - Nasir, Khurram
AU - Bluemke, David A.
AU - Lima, Joao A.C.
N1 - Funding Information:
This study was supported by the National Heart, Lung, and Blood Institute grant (RO1-HL66075-01) and the Multi-Ethnic Study of Atherosclerosis study contracts (NO1-HC-95162, NO1-HC-95168 and NO1-HC-95169). Dr Raymond Yan was supported by fellowship awards from the Canadian Institutes of Health Research and the Royal College of Physicians and Surgeons of Canada.
PY - 2010/9
Y1 - 2010/9
N2 - Background: Increasing evidence suggests that elevated plasma fibrinogen is associated with incident heart failure. However, the underlying pathophysiological mechanisms have not been well elucidated. Methods: We examined the relationship between plasma fibrinogen level and peak systolic midwall circumferential strain (Ecc) at the base, mid cavity, and apex of the left ventricle measured by magnetic resonance imaging myocardial tagging in 1096 participants without clinical cardiovascular disease enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Results: After adjustment for demographics, established risk factors and body mass index, elevated fibrinogen was independently associated with reductions in absolute Ecc indicative of impaired systolic function in all regions (all P ≤ .015). The relationships were consistently significant upon further adjustment for measures of atherosclerosis (all P < .024) and were modestly attenuated with regional heterogeneity after additional adjustment for other inflammatory biomarker and N-terminal pro-brain natriuretic peptide. In this fully-adjusted model, every 1-SD (74 mg/dL) increment in plasma fibrinogen was independently associated with a reduction in left ventricular absolute Ecc of 0.29% (95% CI 0.03%-0.59%, P = .048) at the base, 0.22% (95% CI 0.006%-0.43%, P = .044) at mid cavity, 0.20% (95% CI = -0.035% to 0.43%, P = .097) at the apex, and 0.24% (95% CI = 0.05%-0.43%, P = .015) overall. Conclusions: Among asymptomatic individuals without clinical cardiovascular disease, elevated fibrinogen is independently associated with impaired myocardial systolic function. These findings support roles of inflammation, procoagulation, and hyperviscosity underlying hyperfibrinogenemia in the pathogenesis of incipient myocardial dysfunction.
AB - Background: Increasing evidence suggests that elevated plasma fibrinogen is associated with incident heart failure. However, the underlying pathophysiological mechanisms have not been well elucidated. Methods: We examined the relationship between plasma fibrinogen level and peak systolic midwall circumferential strain (Ecc) at the base, mid cavity, and apex of the left ventricle measured by magnetic resonance imaging myocardial tagging in 1096 participants without clinical cardiovascular disease enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Results: After adjustment for demographics, established risk factors and body mass index, elevated fibrinogen was independently associated with reductions in absolute Ecc indicative of impaired systolic function in all regions (all P ≤ .015). The relationships were consistently significant upon further adjustment for measures of atherosclerosis (all P < .024) and were modestly attenuated with regional heterogeneity after additional adjustment for other inflammatory biomarker and N-terminal pro-brain natriuretic peptide. In this fully-adjusted model, every 1-SD (74 mg/dL) increment in plasma fibrinogen was independently associated with a reduction in left ventricular absolute Ecc of 0.29% (95% CI 0.03%-0.59%, P = .048) at the base, 0.22% (95% CI 0.006%-0.43%, P = .044) at mid cavity, 0.20% (95% CI = -0.035% to 0.43%, P = .097) at the apex, and 0.24% (95% CI = 0.05%-0.43%, P = .015) overall. Conclusions: Among asymptomatic individuals without clinical cardiovascular disease, elevated fibrinogen is independently associated with impaired myocardial systolic function. These findings support roles of inflammation, procoagulation, and hyperviscosity underlying hyperfibrinogenemia in the pathogenesis of incipient myocardial dysfunction.
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U2 - 10.1016/j.ahj.2010.06.001
DO - 10.1016/j.ahj.2010.06.001
M3 - Article
C2 - 20826256
AN - SCOPUS:77956369085
SN - 0002-8703
VL - 160
SP - 479
EP - 486
JO - American heart journal
JF - American heart journal
IS - 3
ER -