Association of Pro-B-Type Natriuretic Peptide With Cardiac Magnetic Resonance-Measured Global and Regional Cardiac Function and Structure Over 10 Years: The MESA Study.

Background NT-proBNP (N-terminal pro-B-type natriuretic peptide) is widely used to diagnose and manage patients with heart failure. We aimed to investigate associations between NT-proBNP levels and development of global and regional myocardial impairment, dyssynchrony, and risk of developing myocardial scar over time. Methods and Results We included 2416 adults (45-84 years) without baseline clinical cardiovascular disease from MESA (Multi-Ethnic Study of Atherosclerosis).

Association between Obstructive Sleep Apnea and Left Ventricular Structure by Age and Gender: the Multi-Ethnic Study of Atherosclerosis.

Study Objectives: The presence and severity of obstructive sleep apnea (OSA) are associated with impaired left ventricular (LV) structure and function. Our goal was to quantify the associations between LV systolic function and mass with severity of OSA in an ethnically diverse cohort, assessing variations by age and sex.

Methods: We conducted a cross-sectional analysis of data from 1,412 racially/ethnically diverse participants across 6 US communities from the Multi-Ethnic Study of Atherosclerosis who underwent both overnight polysomnography and cardiac magnetic resonance imaging from 2010-2012.

Association of subclinical atherosclerosis using carotid intima-media thickness, carotid plaque, and coronary calcium score with left ventricular dyssynchrony: the multi-ethnic Study of Atherosclerosis.

Background: The role of atherosclerosis in the progression of global left ventricular dysfunction and cardiovascular events has been well recognized. Left ventricular (LV) dyssynchrony is a measure of regional myocardial dysfunction. Our objective was to investigate the relationship of subclinical atherosclerosis with mechanical LV dyssynchrony in a population-based asymptomatic multi-ethnic cohort.

Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: the FACTOR-64 randomized clinical trial.

Importance: Coronary artery disease (CAD) is a major cause of cardiovascular morbidity and mortality in patients with diabetes mellitus, yet CAD often is asymptomatic prior to myocardial infarction (MI) and coronary death.

Objective: To assess whether routine screening for CAD by coronary computed tomography angiography (CCTA) in patients with type 1 or type 2 diabetes deemed to be at high cardiac risk followed by CCTA-directed therapy would reduce the risk of death and nonfatal coronary outcomes.

Design, Setting, And Participants: The FACTOR-64 study was a randomized clinical trial in which 900 patients with type 1 or type 2 diabetes of at least 3 to 5 years' duration and without symptoms of CAD were recruited from 45 clinics and practices of a single health system (Intermountain Healthcare, Utah), enrolled at a single-site coordinating center, and randomly assigned to CAD screening with CCTA (n = 452) or to standard national guidelines-based optimal diabetes care (n = 448) (targets: glycated hemoglobin level <7.

Regional myocardial functional patterns: Quantitative tagged magnetic resonance imaging in an adult population free of cardiovascular risk factors: The multi-ethnic study of atherosclerosis (MESA).

Purpose: To characterize the left ventricular (LV) regional deformation patterns and identify normal values of left ventricular strains from tagged magnetic resonance imaging (MRI) in a population with low-risk-factor (LRF) exposure.

Materials And Methods: Tagged CMR on three LV short axis slices was performed in participants of the MESA study who were free of cardiovascular disease at baseline. Images were analyzed by the harmonic phase imaging method to obtain: peak torsion, circumferential (Ecc) and radial (Err) strains, and systolic (SRs) and early-diastolic (SRe) strain rates.

Prognostic implications of left ventricular dyssynchrony for major adverse cardiovascular events in asymptomatic women and men: the Multi-Ethnic Study of Atherosclerosis.

Background: Left ventricular (LV) dyssynchrony is related to adverse outcomes in systolic heart failure, but its prognostic importance in asymptomatic population is not known. Our objective was to assess the prognostic implications of LV mechanical dyssynchrony in a large multiethnic population before the occurrence of global LV dysfunction.

Methods And Results: A total of 1392 participants in the Multi-Ethnic Study of Atherosclerosis (MESA; mean age: 64.

Diagnosis of left ventricular pseudoaneurysm by cardiac CT angiography.

We present a case of a patient with left ventricular pseudoaneurysm which was not noted on transthoracic echocardiography but incidentally detected by CT angiography in preparation of ablation therapy for ventricular tachycardia. The patient underwent successful surgical repair of the pseudoaneurysm. The case illustrates the utility of CT angiography for the diagnosis of this rare, but hazardous condition.

Coronary artery plaque volume and obesity in patients with diabetes: the factor-64 study.

Purpose: To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes.

Materials And Methods: All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.

Resting heart rate as predictor for left ventricular dysfunction and heart failure: MESA (Multi-Ethnic Study of Atherosclerosis).

Objectives: The objective of this study was to investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction.

Background: The association of resting heart rate to HF and LV function has not been well described in an asymptomatic multi-ethnic population.

Methods: Resting heart rate was measured in participants in the MESA (Multi-Ethnic Study of Atherosclerosis) trial at inclusion.

The potential contribution of ranolazine to Torsade de Pointe.

Ranolazine is a novel anti-anginal agent acting through pharmacologic mechanism of inhibition of the late phase of the inward sodium current. In addition, it is a potent inhibitor of rapid delayed rectifier potassium currents, leading to prolongation of the QT interval. However, ranolazine has not yet described to be associated with Torsade de Pointes despite its QT-prolonging effect.

Renin Angiotenin Blocker Pre-treatment and Recurrence After Pulmonary Vein Isolation in Patients with Paroxysmal and Persistent Atrial Fibrillation.

Pulmonary venous isolation has emerged as an effective method for preventing atrial fibrillation (AF) recurrence. Yet, recurrence is common. Angiotensin-receptor-blockers (ARBs) and angiotensin-converting-enzyme-inhibitors (ACEI) are effective in reducing the extent of myocardial remodeling and fibrosis.

Prognostic value of myocardial circumferential strain for incident heart failure and cardiovascular events in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis.

Aims: Left ventricular (LV) circumferential strain (Ecc) is a sensitive index of regional myocardial function. Currently, no studies have assessed its prognostic value in general population. We sought to investigate whether Ecc has a prognostic value for predicting incident heart failure (HF) and other major cardiovascular events in asymptomatic individuals without a history of previous cardiovascular diseases.

The expanding role of computed tomography in the assessment of coronary artery disease and cardiac anatomy.

There are increasing options for noninvasive tests to assess patients with chest pain syndromes or risk factors for atherosclerosis. Choosing the optimal test for an individual patient can be challenging. This review focuses on the expanding role of cardiac computed tomography (CT) and the rationale for its use in different patient groups.

Racial and ethnic differences in subclinical myocardial function: the Multi-Ethnic Study of Atherosclerosis.

Background: Racial/ethnic differences in the incidence and severity of heart failure (HF) are not well understood, but may be related to pre-existing variations in myocardial function.

Objective: To examine racial/ethnic differences in regional myocardial function among asymptomatic individuals free of known cardiovascular disease.

Design, Setting And Patients: The Multi-Ethnic Study of Atherosclerosis is a prospective, observational study of individuals without baseline cardiovascular disease, representing four major racial/ethnic groups.

Usefulness of radial strain mapping by multidetector computer tomography to quantify regional myocardial function in patients with healed myocardial infarction.

We introduce and evaluate strain mapping by multidetector computer tomography as a new noninvasive method for assessment of myocardial function. In patients (n = 16) with healed myocardial infarction, peak systolic radial strain was measured by automated pixel pattern matching analysis of multiple left ventricular 64-slice multidetector computer tomographic short-axis recordings. For comparison, radial strain and myocardial infarct extent were measured by tagged magnetic resonance imaging (MRI) and late enhancement MRI, respectively.

Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis.

Aims: We sought to examine the relationship between circulating interleukin-6 (IL-6) level and regional left-ventricular (LV) function among apparently healthy individuals free of cardiovascular disease.

Methods And Results: Using magnetic resonance myocardial tagging, we determined peak systolic circumferential strain (Ecc) as a measure of regional systolic function in 894 asymptomatic participants in the Multi-Ethnic Study of Atherosclerosis. Ecc was analysed by harmonic phase imaging separately in the LV anterior wall, septum, lateral wall, and inferior wall.

Relationship between baseline coronary calcium score and demonstration of coronary artery stenoses during follow-up MESA (Multi-Ethnic Study of Atherosclerosis).

Objectives: The MESA (Multi-Ethnic Study of Atherosclerosis) is a population-based study of 6,814 men and women. We sought to analyze the relationship between the extent of coronary artery calcium (CAC) at baseline and the severity of coronary stenoses in clinically indicated coronary angiography studies during follow-up.

Background: CAC is an established predictor of major cardiovascular events.

Age, increased left ventricular mass, and lower regional myocardial perfusion are related to greater extent of myocardial dyssynchrony in asymptomatic individuals: the multi-ethnic study of atherosclerosis.

Background: Age and left ventricular (LV) hypertrophy are risk factors for the development of LV dysfunction and congestive heart failure. Our goal was to study the relationships of LV mass and age with myocardial dyssynchrony among asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis.

Methods And Results: A total of 1100 individuals underwent tagged magnetic resonance imaging.

Diastolic suction is impaired by bed rest: MRI tagging studies of diastolic untwisting.

Bed rest deconditioning leads to physiological cardiac atrophy, which may compromise left ventricular (LV) filling during orthostatic stress by reducing diastolic untwisting and suction. To test this hypothesis, myocardial-tagged magnetic resonance imaging (MRI) was performed, and maximal untwisting rates of the endocardium, midwall, and epicardium were calculated by Harmonic Phase Analysis (HARP) before and after -6 degrees head-down tilt bed rest for 18 days with (n = 14) and without exercise training (n = 10). LV mass and LV end-diastolic volume were measured using cine MRI.

The influence of left ventricular size and global function on regional myocardial contraction and relaxation in an adult population free of cardiovascular disease: a tagged CMR study of the MESA cohort.

The purpose of this study is to evaluate the relationship between LV structure and function with regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis, which is a prospective study including 4 ethnic groups free from clinical cardiovascular disease. Peak systolic strain (Ecc) and regional strain rates (SRS and SRE) were calculated by harmonic phase from tagged CMR of 1100 participants. The relationships of ejection fraction (EF), end-systolic volume (ESV) and end-diastolic volume (EDV) with Ecc and strain rate were studied before and after adjustment for cardiovascular risk factors.

Measuring subclinical atherosclerosis: is homocysteine relevant?

Objectives: We systematically reviewed published studies looking at the relationship between total serum homocysteine (tHcy) and subclinical markers of atherosclerosis, such as carotid intimal-medial thickness (C-IMT), coronary artery calcium (CAC) and ankle-brachial index (ABI) in asymptomatic individuals. We analyzed these studies to examine this relationship as well as to guide future avenues of investigation by identifying studies that will help in the inclusion of tHcy levels in current guidelines on atherosclerotic disease management.

Background: tHcy has been known to be associated with clinically evident atherosclerotic disease.

Arterial stiffness is associated with regional ventricular systolic and diastolic dysfunction: the Multi-Ethnic Study of Atherosclerosis.

Objective: The pathophysiology of left ventricular (LV) dysfunction, particularly in the setting of a preserved ejection fraction (EF), remains unclear. Few studies have investigated the relationship between arterial compliance and LV function in humans, and none used cardiovascular MRI.

Methods And Results: We sought to determine whether arterial compliance is related to regional myocardial function among participants of the Multi-Ethnic Study of Atherosclerosis (MESA).

Enhanced infarct border zone function and altered mechanical activation predict inducibility of monomorphic ventricular tachycardia in patients with ischemic cardiomyopathy.

Purpose: To prospectively determine whether mechanical behavior of left ventricular wall segments that contain different degrees of scar tissue and are located at different distances from the interface between infarcted and noninfarcted myocardial tissue can help predict inducibility of monomorphic ventricular tachycardia (VT) in patients with ischemic cardiomyopathy.

Materials And Methods: This HIPAA-compliant study was institutional review board approved; written informed consent was obtained from all patients. Forty-six patients (36 men, 10 women; mean age +/- standard deviation, 61.