TY - JOUR
T1 - Relationship Between C-Reactive Protein Levels and Regional Left Ventricular Function in Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis
AU - Rosen, Boaz D.
AU - Cushman, Mary
AU - Nasir, Khurram
AU - Bluemke, David A.
AU - Edvardsen, Thor
AU - Fernandes, Verônica
AU - Lai, Shenghan
AU - Tracy, Russell P.
AU - Lima, João 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. Lima is also supported by the Johns Hopkins Reynolds Center, and Dr. Rosen is supported by the Israeli Heart Society and the Organization of American Physician Fellowship for Medicine in Israel. Peter Libby, MD, acted as Guest Editor for this article.
PY - 2007/2/6
Y1 - 2007/2/6
N2 - Objectives: This study sought to investigate the relationship between C-reactive protein (CRP) and regional left ventricular (LV) function in asymptomatic individuals without a history of cardiovascular disease. Background: C-reactive protein is associated with an increased risk for developing cardiovascular disease. However, the relationship between CRP and subclinical LV dysfunction has not been evaluated in asymptomatic individuals. Methods: Regional myocardial function was analyzed as peak systolic circumferential shortening strain (Ecc) using the harmonic-phase method by tagged magnetic resonance imaging in 1,164 individuals without symptomatic cardiovascular disease from the MESA (Multi-Ethnic Study of Atherosclerosis) trial (age 66.4 ± 9.6 years old). Regions were defined by coronary territories: left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). The relationship between log-CRP concentration and Ecc was studied by multivariable linear regression after adjustment for demographic characteristics, risk factors, and therapy (including hormone replacement therapy). Results: For each region, associations differed by gender with no association of CRP and regional LV function among women. In men, after adjustment, higher log-CRP was significantly associated with lower (absolute) Ecc in the LAD and RCA regions (regression coefficient 0.37 per unit higher log-CRP [95% confidence interval [CI] 0.08 to 0.65] and 0.31 [95% CI 0.02 to 0.59], respectively) and peak systolic Ecc overall (regression coefficient 0.32 [95% CI 0.05 to 0.58]). In the LCX region, the association was weaker (p = 0.06). Conclusions: Among individuals without evident heart failure or other cardiovascular disorders, higher CRP was associated with lower systolic myocardial function in all regions in men but not in women. These findings support the role of inflammation and atherosclerosis in incipient myocardial dysfunction. (Multi-Ethnic Study of Atherosclerosis; http://clinicaltrials.gov/ct/show/NCT00005487).
AB - Objectives: This study sought to investigate the relationship between C-reactive protein (CRP) and regional left ventricular (LV) function in asymptomatic individuals without a history of cardiovascular disease. Background: C-reactive protein is associated with an increased risk for developing cardiovascular disease. However, the relationship between CRP and subclinical LV dysfunction has not been evaluated in asymptomatic individuals. Methods: Regional myocardial function was analyzed as peak systolic circumferential shortening strain (Ecc) using the harmonic-phase method by tagged magnetic resonance imaging in 1,164 individuals without symptomatic cardiovascular disease from the MESA (Multi-Ethnic Study of Atherosclerosis) trial (age 66.4 ± 9.6 years old). Regions were defined by coronary territories: left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). The relationship between log-CRP concentration and Ecc was studied by multivariable linear regression after adjustment for demographic characteristics, risk factors, and therapy (including hormone replacement therapy). Results: For each region, associations differed by gender with no association of CRP and regional LV function among women. In men, after adjustment, higher log-CRP was significantly associated with lower (absolute) Ecc in the LAD and RCA regions (regression coefficient 0.37 per unit higher log-CRP [95% confidence interval [CI] 0.08 to 0.65] and 0.31 [95% CI 0.02 to 0.59], respectively) and peak systolic Ecc overall (regression coefficient 0.32 [95% CI 0.05 to 0.58]). In the LCX region, the association was weaker (p = 0.06). Conclusions: Among individuals without evident heart failure or other cardiovascular disorders, higher CRP was associated with lower systolic myocardial function in all regions in men but not in women. These findings support the role of inflammation and atherosclerosis in incipient myocardial dysfunction. (Multi-Ethnic Study of Atherosclerosis; http://clinicaltrials.gov/ct/show/NCT00005487).
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U2 - 10.1016/j.jacc.2006.09.040
DO - 10.1016/j.jacc.2006.09.040
M3 - Article
C2 - 17276184
AN - SCOPUS:33846614109
SN - 0735-1097
VL - 49
SP - 594
EP - 600
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 5
ER -