Abstract
Background: Left ventricular (LV) structure and function are important independent predictors of cardiovascular events, but the relationship of these parameters to indices of subclinical atherosclerosis has not been evaluated in an asymptomatic population. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) includes 6,814 men and women, aged 45– 85 years; white, African-American, Hispanics, and Chinese. LV parameters were measured by MRI. Measures of subclinical atherosclerosis included carotid intima-media thickness (IMT) determined by high-resolution B-mode ultrasonography and coronary artery calcification (CAC) defined as phantom-adjusted Agatston calcium score from brightness adjusted CT images. Results: In univariable analyses, LV mass index, LV ejection fraction (LVEF), and LV end-diastolic volume (EDV) were significantly associated with both the presence and the extent of CAC as well as with carotid IMT (Table ). But after adjustment for traditional risk factors, the magnitudes of the associations decreased considerably. Although the relationship of LV mass with carotid IMT and CAC remained statistically significant, the associations of LVEF and EDV with CAC and IMT were not significant in multivariable analyses. LV ejection fraction and LV end-diastolic volume were also associated with CAC and IMT in univariable analyses, but these associations were not significant in multivariable analyses. Although there was no significant effect modification by ethnicity, the association of LV mass with CAC was stronger in African Americans and Hispanics, compared to Caucasians and Chinese Americans. Conclusions: Subclinical atherosclerosis is associated with increased LV mass and decreased LV function. However, these associations may be in part due to the relationship of traditional risk factors for atherosclerosis with LV structure and function, independent of an atherosclerotic process.
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