Left Ventricular Mass at MRI and Long-term Risk of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)
Left Ventricular Mass at MRI and Long-term Risk of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)
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DOI：
10.1148/radiol.2019182871
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发表时间：
2019-10-01
期刊：
影响因子：
19.7
通讯作者：
Bluemke, David A.
中科院分区：
文献类型：
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作者：
Kawel-Boehm, Nadine;Kronmal, Richard;Bluemke, David A.
背景资料：在一个当代的、种族多样的队列中，通过MRI定量的It-ft心室（LV）质量升高对心血管（CV）事件的Ion -term风险预测的数据很少。目的：在一个多种族人群的前瞻性队列研究中，评估LV质量升高对V事件的长期影响，与风险因素和冠状动脉钙（CAC）评分有关。材料和方法：多种族动脉粥样硬化研究（梅萨）（ClinicalTrials.gov：NCT 00005487）是一项正在美国进行的前瞻性多中心人群研究。2000年至2002年期间，共招募了6814名基线时无临床CV疾病的受试者（年龄范围：45-84岁）。在4988例受试者（2613例[52.4%]女性;平均年龄62岁+/- 10.1 [标准差]）中，CV事件随访超过15年，在中心核心实验室使用半自动软件从基线入组时的心脏MRI中推导IV质量。应用考克斯比例风险模型、Kaplan-Meier曲线和z评分评估EV hypertrophy.Results的影响：共有290名参与者发生了严重的冠心病（CHD）事件（207例心肌梗死[MI]，95例CHD死亡），57例发生了其他CV疾病相关死亡，215例发生了心力衰竭（HF）。左室肥厚是严重冠心病事件的独立预测因子（风险比[HR]：2.7; 95%置信区间[CI]：1.9，3.8），MI（HR：2.8; 95% CI：1.8，4.0），CHD死亡（HR：4.3; 95% CI：2.5，7.3），其他CV死亡（HR：7.5; 95% CI：4.2，13.5）和HF（HR：5.4; 95% CI：3.8，7.5）（所有终点P <0.001）。对于CHD死亡、其他CV死亡和HF，LV肥大是比CAC更强的预测因子（LV肥大vs CAC的z评分分别为5.4 vs 3.4、6.8 vs 2.4和9.7 vs 3.2）。Kaplan-Meier分析表明，心血管事件的参与者与左心室肥厚的风险增加，特别是在5 years.Conclusion：左心室质量升高与硬冠心病事件，其他心血管死亡，心力衰竭超过15年的随访，独立于传统的危险因素和冠状动脉钙化评分。(C)RSNA，2019
Background: Few data exist on the Ion -term risk prediction of elevated It-ft ventricular (LV) mass quantified by MRI for cardiovascular (CV) events in a contemporary, ethnically diverse cohort.Purpose: To assess the long-term impact of elevated LV mass on V events in a prospective cohort study of a multiethnic population in relationship to risk factors and coronary artery calcium (CAC) score.Materials and Methods: The Multi-Ethnic Study of Atherosclerosis, or MESA (ClinicalTrials.gov: NCT00005487), is an ongoing prospective multicenter population-based study in the United States. A total of 6814 participants (age range, 45-84 years) free of clinical CV disease at baseline were enrolled between 2000 and 2002. In 4988 participants (2613 [52.4%] women; mean age, 62 years +/- 10.1 [standard deviation]) followed over 15 years for CV events, IV mass was derived from cardiac MRI at baseline enrollment by using semiautomated software at a central core laboratory. Cox proportional hazard models, Kaplan-Meier curves, and z scores were applied to assess the impact of EV hypertrophy.Results: A total of 290 participants had hard coronary heart disease (CHD) events (207 myocardial infarctions [MIs], 95 CHD deaths), 57 had other CV disease related deaths, and 215 had heart failure (HF). LV hypertrophy was an independent predictor of hard CHD events (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.9, 3.8), MI (HR: 2.8; 95% CI: 1.8, 4.0), CHD death (HR: 4.3; 95% CI: 2.5, 7.3), other CV death (HR: 7.5; 95% CI: 4.2, 13.5), and HF (HR: 5.4; 95% CI: 3.8, 7.5) (P < .001 for all end points). LV hypertrophy was a stronger predictor than CAC for CHD death, other CV death, and HF (z scores: 5.4 vs 3.4, 6.8 vs 2.4, and 9.7 vs 3.2 for LV hypertrophy vs CAC, respectively). Kaplan-Meier analysis demonstrated an increased risk of CV events in participants with LV hypertrophy, particularly after 5 years.Conclusion: Elevated left ventricular mass was strongly associated with hard coronary heart disease events, other cardiovascular death, and heart failure over 15 years of follow-up, independent of traditional risk factors and coronary artery calcium score. (C) RSNA, 2019