Author + information
- Matthew N. Petersa,b,
- Stephen Seligera,b,
- Susie Hong-Zohlmana,b,
- James de Lemosa,b,
- Joao Limaa,b,
- Lori Danielsa,b,
- Robert Christensona,b,
- Alain Bertonia,b and
- Christopher DeFilippia,b
Background: Left ventricular hypertrophy (LVH) represents an established risk factor for adverse cardiovascular disease (CVD) outcomes and, specifically, heart failure (HF). Recent studies have demonstrated that LVH in conjunction with markers for myocardial injury: hs-cTnT, and hemodynamic stress: NT-proBNP, may identify a “malignant” phenotype of LVH at enhanced risk for progression to HF in a community-based population. The goal of the present study was to determine if “malignant” LVH differentially predicted HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF).
Methods: Of 6,814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study (age 45-84 years) all free of known CVD, 4,985 underwent cardiac MRI for LVH assessment and had hs-cTnT and NT-proBNP measured. HFrEF was defined as LVEF<50% during the HF event. Elevated biomarker levels were defined as the upper tertile adjusted by decade of age.
Results: Over a median follow-up of 12.2 years there were 177 HF hospitalizations (87 HFrEF, 72 HFpEF, 13 unknown EF). The table shows the hazard ratios for incident HF subtype based on LVH and biomarker phenotypes.
Conclusions: The presence of a “malignant” LVH phenotype identifies CVD free subjects at high-risk for incident HF, particularly HFrEF. Identification of “malignant” LVH with imaging and soluble cardiac specific biomarkers may identify an attractive target for HFrEF prevention strategies in the general population.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-266
- 2017 American College of Cardiology Foundation