Author + information
- Matthew N. Petersa,b,
- Stephen Seligera,b,
- Susie Hong-Zohlmana,b,
- Robert Christensona,b,
- James de Lemosa,b,
- Joao Limaa,b,
- Alain Bertonia,b,
- Lori Danielsa,b and
- Christopher DeFilippia,b
Background: The combination of left ventricular hypertrophy (LVH) with cardiac specific biomarker evidence of injury: high-sensitivity cardiac troponin T (hs-cTnT) or subtle hemodynamic stress: amino-terminal proBNP (NT-proBNP) has been previously shown to identify a “malignant” phenotype of LVH at enhanced risk for progression to heart failure (HF). Our goal was to determine if presence of “malignant” LVH also identified an increased risk for asymptomatic LV systolic dysfunction.
Methods: Of 6,814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study (age 45-84 years) all free of cardiovascular disease (CVD), 2,831 were included in this analysis based on the following characteristics: a cardiac MRI at baseline and after 10-years; a baseline LVEF >50%; a baseline measure of hs-cTnT and NT-proBNP, and remained HF free. An abnormal LVEF was defined as ≤50%. Elevated biomarker levels were defined as the upper tertile per decade of age.
Results: During the 10-year interval between cardiac MRI studies, 109 subjects developed an asymptomatic decrease in LVEF to <50%. The risk based on LVH and biomarkers is shown in the table. Individuals with LVH and elevated biomarkers were significantly more likely to develop new asymptomatic systolic dysfunction after risk factor adjustment.
Conclusions: The presence of “malignant” LVH in subjects without symptomatic CVD was associated with an increased incidence of LV systolic dysfunction and identifies a group that may be targeted for prevention.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Innovations in Cardiovascular Risk Assessment and Reduction
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1235-046
- 2017 American College of Cardiology Foundation