Left ventricular concentric remodeling is associated with decreased global and regional systolic function: the Multi-Ethnic Study of Atherosclerosis.
BACKGROUND
The transition from compensatory concentric remodeling to myocardial failure is not completely understood in humans. To investigate determinants of incipient myocardial dysfunction, we examined the association between concentric remodeling and regional LV function in asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis (MESA).


RESULTS
Myocardial tagged MRI was performed. Regional myocardial function expressed as peak systolic midwall circumferential strain (Ecc) was analyzed in 441 consecutive studies by HARP (Harmonic Phase) tool. Peak Ecc was correlated with the extent of concentric remodeling determined by the ratio of left ventricular mass to end-diastolic volume (M/V ratio). In men, a gradual decline in peak global Ecc was seen with increasing M/V ratio (test for trend, P<0.001). Among women, however, Ecc tended to be lower only in the fifth compared with the first quintile of M/V ratio (P=0.1). The association of lower Ecc with increasing M/V ratio was regionally heterogeneous but was particularly prominent in the LAD region in men (test for trend, P<0.001) and in women (test for trend, P=0.02). In the right coronary and left circumflex artery territories, these associations were less marked in both genders.


CONCLUSIONS
In this cross-sectional study of asymptomatic individuals, concentric left ventricular remodeling was related to decreased regional systolic function. The reduction in regional function, which was more pronounced in the left anterior descending coronary artery territory, may reflect the local transition from compensatory remodeling to myocardial dysfunction.
Rosen
Boaz D
BD
Cardiology Division, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Edvardsen
Thor
T
Lai
Shenghan
S
Castillo
Ernesto
E
Pan
Li
L
Jerosch-Herold
Michael
M
Sinha
Shantanu
S
Kronmal
Richard
R
Arnett
Donna
D
Crouse
John R
JR
Heckbert
Susan R
SR
Bluemke
David A
DA
Lima
Joao A C
JA
D050197:Atherosclerosis / Q000453:epidemiology*; D003331:Coronary Vessels / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005006:Ethnicity; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008955:Models, Cardiovascular; D013599:Systole / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*