학술논문
Association of myocardial fibrosis and cardiovascular events: the multi-ethnic study of atherosclerosis.
Document Type
Academic Journal
Author
Ambale-Venkatesh B; Johns Hopkins University, MR 110 Radiology, Nelson Basement, 600 N Wolfe Street, Baltimore, MD, USA.; Liu CY; Johns Hopkins University, MR 110 Radiology, Nelson Basement, 600 N Wolfe Street, Baltimore, MD, USA.; Liu YC; Cardiology, Johns Hopkins Hospital, Blalock 524, 600 N Wolfe Street, Baltimore, MD, USA.; Donekal S; Cardiology, Johns Hopkins Hospital, Blalock 524, 600 N Wolfe Street, Baltimore, MD, USA.; Ohyama Y; Cardiology, Johns Hopkins Hospital, Blalock 524, 600 N Wolfe Street, Baltimore, MD, USA.; Sharma RK; Cardiology, Johns Hopkins Hospital, Blalock 524, 600 N Wolfe Street, Baltimore, MD, USA.; Wu CO; Office of Biostatistics Research, 2 Rockledge Center, Room 9212, 6701 Rockledge Drive, Bethesda, MD, USA.; Post WS; Cardiology, Johns Hopkins Hospital, Halsted 566, 600 N Wolfe St, Baltimore, MD, USA.; Hundley GW; Wake Forest University Health Sciences, Department of Internal Medicine/Cardiology, Medical Center Blvd., Winston-Salem, NC, USA.; Bluemke DA; University of Wisconsin School of Medicine and Public Health, Department of Radiology, 600 Highland Avenue, Madison, WI, USA.; Lima JAC; Cardiology, Johns Hopkins Hospital, Blalock 524, 600 N Wolfe Street, Baltimore, MD, USA.
Source
Publisher: Oxford University Press Country of Publication: England NLM ID: 101573788 Publication Model: Print Cited Medium: Internet ISSN: 2047-2412 (Electronic) Linking ISSN: 20472404 NLM ISO Abbreviation: Eur Heart J Cardiovasc Imaging Subsets: MEDLINE
Subject
Language
English
Abstract
Aims: We used contrast-enhanced cardiac magnetic resonance (CMR) to evaluate differences in myocardial fibrosis measured at the year-10 examination between participants with and without cardiovascular (CV) events accrued in a large population based study over the preceding 10-year follow-up period in this retrospective study.
Methods and Results: The MESA study enrolled 6814 participants free of CV disease at baseline (2000-2002). We included MESA participants who underwent contrast-enhanced CMR at the MESA year-10 exam (N = 1840). We defined a composite CV endpoint of coronary heart disease, heart failure, atrial fibrillation, stroke, and peripheral artery disease. Using CMR, we characterized myocardial fibrosis with late-gadolinium enhancement for scar and T1 mapping indices of diffuse fibrosis. Demographic and CV-risk adjusted logistic (presence of scar) and linear regression (pre-contrast T1, T1 at 12 and 25 min post-contrast, and extracellular volume fraction or ECV) models were used to assess the relationship between fibrosis and events. The mean values of T1 indices were-pre-contrast T1: 977 ± 45 ms; T1 at 12': 456 ± 40 ms; T1 at 25': 519 ± 41 ms; ECV: 27.1 ± 3.2%. One-hundred and forty-six (7.9%) participants had myocardial scar. The presence of scar was strongly associated with prior CV events (adjusted coeff: 1.36, P < 0.001). Lower post-contrast T1 times and higher ECV, indicative of greater diffuse fibrosis were strongly associated with CV events (T1 at 12': coeff = -10.0 ms, P = 0.004; T1 at 25': coeff =-9.2 ms, P = 0.008; ECV: coeff = 1.31%, P < 0.001).
Conclusion: Individuals who suffered prior CV events have greater likelihood of diffuse myocardial fibrosis when compared with event-free individuals living in the same community.
Methods and Results: The MESA study enrolled 6814 participants free of CV disease at baseline (2000-2002). We included MESA participants who underwent contrast-enhanced CMR at the MESA year-10 exam (N = 1840). We defined a composite CV endpoint of coronary heart disease, heart failure, atrial fibrillation, stroke, and peripheral artery disease. Using CMR, we characterized myocardial fibrosis with late-gadolinium enhancement for scar and T1 mapping indices of diffuse fibrosis. Demographic and CV-risk adjusted logistic (presence of scar) and linear regression (pre-contrast T1, T1 at 12 and 25 min post-contrast, and extracellular volume fraction or ECV) models were used to assess the relationship between fibrosis and events. The mean values of T1 indices were-pre-contrast T1: 977 ± 45 ms; T1 at 12': 456 ± 40 ms; T1 at 25': 519 ± 41 ms; ECV: 27.1 ± 3.2%. One-hundred and forty-six (7.9%) participants had myocardial scar. The presence of scar was strongly associated with prior CV events (adjusted coeff: 1.36, P < 0.001). Lower post-contrast T1 times and higher ECV, indicative of greater diffuse fibrosis were strongly associated with CV events (T1 at 12': coeff = -10.0 ms, P = 0.004; T1 at 25': coeff =-9.2 ms, P = 0.008; ECV: coeff = 1.31%, P < 0.001).
Conclusion: Individuals who suffered prior CV events have greater likelihood of diffuse myocardial fibrosis when compared with event-free individuals living in the same community.