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Age-Related Left Ventricular Remodeling and Associated Risk for Cardiovascular Outcomes The Multi-Ethnic Study of Atherosclerosis Susan Cheng, MD; Veroˆnica R.S. Fernandes, MD, PhD; David A. Bluemke, MD, PhD; Robyn L. McClelland, PhD; Richard A. Kronmal, PhD; Joa˜o A.C. Lima, MD Background—Age-related alterations of left ventricular (LV) structure and function that may predispose to cardiovascular events are not well understood. Methods and Results—We used cardiac MRI to examine age-related differences in LV structure and function in 5004 participants without overt cardiovascular disease when enrolled in the Multi-Ethnic Study of Atherosclerosis; 1099 participants received additional strain analyses by MRI tagging. We also assessed the relation of age-associated remodeling with cardiovascular outcomes using Cox proportional hazard models adjusting for cardiovascular risk factors. Although LV mass decreased with age (0.3 g per year), the mass-to-volume ratio markedly increased (5 mg/mL per year, P0.0001), driven by a substantial reduction in end-diastolic volume (0.8 mL per year, P0.0001). Age was also associated with a significant fall in stroke volume (0.4 mL per year, P0.0001), along with strain patterns reflecting systolic (P0.0001) as well as diastolic (P0.01) myocardial dysfunction—despite a modestly enhanced ejection fraction (0.1% per year, P0.0001). Increased mass-to-volume ratio conferred a significant risk for
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: May 1, 2009
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