Abstract 16614: Left Ventricular Global Function Index (A Novel Marker of Cardiac Performance) Predicts Incident Cardiovascular Events: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Introduction: Left ventricle (LV) function is typically evaluated independent of LV structure and vice versa. LV global function index (LVGFI) is a novel marker of cardiac performance that accounts for LV structural alterations and has been previously validated using magnetic resonance imaging. Hypothesis: We evaluated the prognostic utility of LVGFI assessed by echocardiography for incident cardiovascular disease (CVD) and heart failure (HF) events in comparison to LV ejection fraction (LVEF) and LV mass Methods: Included were 4107 Coronary Artery Risk Development in Young Adults (CARDIA) study participants with available m-mode echocardiographic parameters in 1990-1991 (Year-5). LV volumes were obtained using the Teichholz formula. LVGFI defined as LV stroke volume/LV global volume* 100, where LV global volume was calculated as the sum of the LV mean cavity volume (LVEDV + LVESV)/2) and myocardium volume (LV mass/density). Median follow-up time was 21.9 years. Cox regression models, adjusted for risk factors, were utilized to predict the endpoints of HF, hard CVD and all CVD events. Results: Mean age of participants at Year-5 was 29.8 ± 3.7 years, 55% were female, 51.3% white and mean LVGFI was 34.7 ± 6.2%. A total of 174 incident CVD events were observed during the 21.9 years median follow-up. In multivariable adjusted models, 1-SD increase in LVGFI was significantly associated with lower hazard of HF, Hazard Ratio (HR) =0.55 95% confidence interval (CI) [0.40 - 0.74]; hard CVD, HR=0.74 95% CI [0.63 - 0.88] and all CVD events, HR=0.76 95% CI [0.65 -0.88]. (Table 1). LVGFI provided incremental predictive value for incident CVD compared to LV mass and LV ejection fraction alone.(Figure 1). Conclusions: LVGFI in early adulthood was associated with incident HF, hard CVD and all CVD events. In this longitudinal community study, LVGFI provided robust, independent and incremental predictive value for incident CVD events.