Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis (MESA)

Verônica R S Fernandes, Joseph F. Polak, Thor Edvardsen, Benilton Carvalho, Antoinette Gomes, David A. Bluemke, Khurram Nasir, Daniel H. O'Leary, Joao Lima

Research output: Contribution to journalArticle

Abstract

Objectives: This study sought to determine whether increased carotid intima-media thickness (IMT) is related to reduced regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Background: Carotid artery IMT is an established index of subclinical atherosclerosis, and tagged magnetic resonance imaging (MRI) can detect incipient alterations of segmental function that precede overt myocardial failure. Methods: The MESA study is a prospective observational study including four ethnic groups free from clinical cardiovascular disease. Peak midwall systolic circumferential strain (ECC) and regional strain rates were calculated by harmonic phase from tagged MRI data of 500 participants. Systolic ECC and diastolic strain rate were regressed on IMT of the common carotid artery defined by ultrasound, with adjustments for body mass index, blood pressure, cholesterol, diabetes, smoking, left ventricular hypertrophy, C-reactive protein, age, and gender. Results: The mean participant age was 66 ± 10 years (mean ± SD). Among the 58 participants, 4% were male and the interquartile (25th to 75th percentile) range for IMT was 0.25 mm. Multiple linear regression analyses showed that increased IMT was related to reduced systolic regional function (less shortening ECC) in all myocardial regions (p <0.05), except in the inferior wall. The analyses also showed that greater IMT was associated with a lower diastolic strain rate (diastolic reduced function) in all regions (p <0.01), except in the anterior wall. Conclusions: Greater carotid IMT is associated with alterations of myocardial strain parameters reflecting reduced systolic and diastolic myocardial function. These observations indicate a relationship between subclinical atherosclerosis and incipient myocardial dysfunction in a population free of clinical heart disease.

Original languageEnglish (US)
Pages (from-to)2420-2428
Number of pages9
JournalJournal of the American College of Cardiology
Volume47
Issue number12
DOIs
StatePublished - Jun 20 2006

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Carotid Intima-Media Thickness
Atherosclerosis
Magnetic Resonance Imaging
Common Carotid Artery
Left Ventricular Hypertrophy
Carotid Arteries
Ethnic Groups
C-Reactive Protein
Observational Studies
Linear Models
Heart Diseases
Body Mass Index
Cardiovascular Diseases
Heart Failure
Smoking
Cholesterol
Regression Analysis
Prospective Studies
Blood Pressure
Population

ASJC Scopus subject areas

  • Nursing(all)

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Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis (MESA). / Fernandes, Verônica R S; Polak, Joseph F.; Edvardsen, Thor; Carvalho, Benilton; Gomes, Antoinette; Bluemke, David A.; Nasir, Khurram; O'Leary, Daniel H.; Lima, Joao.

In: Journal of the American College of Cardiology, Vol. 47, No. 12, 20.06.2006, p. 2420-2428.

Research output: Contribution to journalArticle

Fernandes, Verônica R S ; Polak, Joseph F. ; Edvardsen, Thor ; Carvalho, Benilton ; Gomes, Antoinette ; Bluemke, David A. ; Nasir, Khurram ; O'Leary, Daniel H. ; Lima, Joao. / Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis (MESA). In: Journal of the American College of Cardiology. 2006 ; Vol. 47, No. 12. pp. 2420-2428.
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AU - Polak, Joseph F.

AU - Edvardsen, Thor

AU - Carvalho, Benilton

AU - Gomes, Antoinette

AU - Bluemke, David A.

AU - Nasir, Khurram

AU - O'Leary, Daniel H.

AU - Lima, Joao

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Y1 - 2006/6/20

N2 - Objectives: This study sought to determine whether increased carotid intima-media thickness (IMT) is related to reduced regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Background: Carotid artery IMT is an established index of subclinical atherosclerosis, and tagged magnetic resonance imaging (MRI) can detect incipient alterations of segmental function that precede overt myocardial failure. Methods: The MESA study is a prospective observational study including four ethnic groups free from clinical cardiovascular disease. Peak midwall systolic circumferential strain (ECC) and regional strain rates were calculated by harmonic phase from tagged MRI data of 500 participants. Systolic ECC and diastolic strain rate were regressed on IMT of the common carotid artery defined by ultrasound, with adjustments for body mass index, blood pressure, cholesterol, diabetes, smoking, left ventricular hypertrophy, C-reactive protein, age, and gender. Results: The mean participant age was 66 ± 10 years (mean ± SD). Among the 58 participants, 4% were male and the interquartile (25th to 75th percentile) range for IMT was 0.25 mm. Multiple linear regression analyses showed that increased IMT was related to reduced systolic regional function (less shortening ECC) in all myocardial regions (p <0.05), except in the inferior wall. The analyses also showed that greater IMT was associated with a lower diastolic strain rate (diastolic reduced function) in all regions (p <0.01), except in the anterior wall. Conclusions: Greater carotid IMT is associated with alterations of myocardial strain parameters reflecting reduced systolic and diastolic myocardial function. These observations indicate a relationship between subclinical atherosclerosis and incipient myocardial dysfunction in a population free of clinical heart disease.

AB - Objectives: This study sought to determine whether increased carotid intima-media thickness (IMT) is related to reduced regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Background: Carotid artery IMT is an established index of subclinical atherosclerosis, and tagged magnetic resonance imaging (MRI) can detect incipient alterations of segmental function that precede overt myocardial failure. Methods: The MESA study is a prospective observational study including four ethnic groups free from clinical cardiovascular disease. Peak midwall systolic circumferential strain (ECC) and regional strain rates were calculated by harmonic phase from tagged MRI data of 500 participants. Systolic ECC and diastolic strain rate were regressed on IMT of the common carotid artery defined by ultrasound, with adjustments for body mass index, blood pressure, cholesterol, diabetes, smoking, left ventricular hypertrophy, C-reactive protein, age, and gender. Results: The mean participant age was 66 ± 10 years (mean ± SD). Among the 58 participants, 4% were male and the interquartile (25th to 75th percentile) range for IMT was 0.25 mm. Multiple linear regression analyses showed that increased IMT was related to reduced systolic regional function (less shortening ECC) in all myocardial regions (p <0.05), except in the inferior wall. The analyses also showed that greater IMT was associated with a lower diastolic strain rate (diastolic reduced function) in all regions (p <0.01), except in the anterior wall. Conclusions: Greater carotid IMT is associated with alterations of myocardial strain parameters reflecting reduced systolic and diastolic myocardial function. These observations indicate a relationship between subclinical atherosclerosis and incipient myocardial dysfunction in a population free of clinical heart disease.

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