Long Term Effects of Subclinical CAD on Cardiac Function

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DESCRIPTION (provided by applicant): The South Bay Heart Watch (SBHW) study has established the presence of a strong relationship between coronary calcium and future incident coronary heart disease in asymptomatic adults at risk. The objective of the proposed continuation of the SBHW is to examine the effect of baseline calcium and seven-year change in calcium extent on left ventricular systolic and diastolic function in the SBHW cohort. We will accomplish these goals by studying 775 South Bay Heart Watch survivors with cardiac magnetic resonance imaging (MRI) for measurement of systolic and diastolic function. Primary MRI endpoints are systolic function (ejection fraction) and diastolic function (peak filling rate). Multiple linear and logistic regression analyses will be utilized to evaluate the effect of the baseline 1993-1994 coronary calcium score on diastolic and systolic left ventricular function. We will evaluate the mediating effect of intervening myocardial infarction and MRI determined left ventricular mass, after adjusting for demographic and standard risk factors I including the use of relevant medications. We will also explore hypotheses relating to changes in calcium score between the two CT scans done over an interval of 7 years and left ventricular dysfunction after ten years in 700 participants with baseline and follow-up calcium scores and MRI scans. The study will also examine the relation between changes in coronary calcium and future incident coronary heart disease in 810 participants with baseline and follow-up calcium scores, including those without MRI scans. The proposed research will determine the presence and extent of a link between sub-clinical atherosclerosis and its progression and subsequent cardiac function.