Fibrinogen and left ventricular myocardial systolic function: The Multi-Ethnic Study of Atherosclerosis (MESA)

Raymond T. Yan, Veronica Fernandes, Andrew T. Yan, Mary Cushman, Alban Redheuil, Russell Tracy, Jens Vogel-Claussen, Hossein Bahrami, Khurram Nasir, David A. Bluemke, Joao Lima

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)479-486
Number of pages8
JournalAmerican Heart Journal
Volume160
Issue number3
DOIs
StatePublished - 2010

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Fibrinogen
Atherosclerosis
Cardiovascular Diseases
Brain Natriuretic Peptide
Heart Ventricles
Body Mass Index
Heart Failure
Biomarkers
Magnetic Resonance Imaging
Demography
Inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Fibrinogen and left ventricular myocardial systolic function : The Multi-Ethnic Study of Atherosclerosis (MESA). / Yan, Raymond T.; Fernandes, Veronica; Yan, Andrew T.; Cushman, Mary; Redheuil, Alban; Tracy, Russell; Vogel-Claussen, Jens; Bahrami, Hossein; Nasir, Khurram; Bluemke, David A.; Lima, Joao.

In: American Heart Journal, Vol. 160, No. 3, 2010, p. 479-486.

Research output: Contribution to journalArticle

Yan, RT, Fernandes, V, Yan, AT, Cushman, M, Redheuil, A, Tracy, R, Vogel-Claussen, J, Bahrami, H, Nasir, K, Bluemke, DA & Lima, J 2010, 'Fibrinogen and left ventricular myocardial systolic function: The Multi-Ethnic Study of Atherosclerosis (MESA)', American Heart Journal, vol. 160, no. 3, pp. 479-486. https://doi.org/10.1016/j.ahj.2010.06.001
Yan, Raymond T. ; Fernandes, Veronica ; Yan, Andrew T. ; Cushman, Mary ; Redheuil, Alban ; Tracy, Russell ; Vogel-Claussen, Jens ; Bahrami, Hossein ; Nasir, Khurram ; Bluemke, David A. ; Lima, Joao. / Fibrinogen and left ventricular myocardial systolic function : The Multi-Ethnic Study of Atherosclerosis (MESA). In: American Heart Journal. 2010 ; Vol. 160, No. 3. pp. 479-486.
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abstract = "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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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

PY - 2010

Y1 - 2010

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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