title: Subclinical atherosclerosis and incipient regional myocardial dysfunction in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  This study sought to determine whether increased carotid intima-media thickness (IMT) is related to reduced regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis (MESA).
  
  
  BACKGROUND
  Carotid artery IMT is an established index of subclinical atherosclerosis, and tagged magnetic resonance imaging (MRI) can detect incipient alterations of segmental function that precede overt myocardial failure.
  
  
  METHODS
  The MESA study is a prospective observational study including four ethnic groups free from clinical cardiovascular disease. Peak midwall systolic circumferential strain (ECC) and regional strain rates were calculated by harmonic phase from tagged MRI data of 500 participants. Systolic ECC and diastolic strain rate were regressed on IMT of the common carotid artery defined by ultrasound, with adjustments for body mass index, blood pressure, cholesterol, diabetes, smoking, left ventricular hypertrophy, C-reactive protein, age, and gender.
  
  
  RESULTS
  The mean participant age was 66 +/- 10 years (mean +/- SD). Among the 58 participants, 4% were male and the interquartile (25th to 75th percentile) range for IMT was 0.25 mm. Multiple linear regression analyses showed that increased IMT was related to reduced systolic regional function (less shortening ECC) in all myocardial regions (p < 0.05), except in the inferior wall. The analyses also showed that greater IMT was associated with a lower diastolic strain rate (diastolic reduced function) in all regions (p < 0.01), except in the anterior wall.
  
  
  CONCLUSIONS
  Greater carotid IMT is associated with alterations of myocardial strain parameters reflecting reduced systolic and diastolic myocardial function. These observations indicate a relationship between subclinical atherosclerosis and incipient myocardial dysfunction in a population free of clinical heart disease.
authors.affiliation: Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Verônica R S
authors.initials: VR
authors.lastname: Fernandes
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.forename: Benilton
authors.initials: B
authors.lastname: Carvalho
authors.forename: Antoinette
authors.initials: A
authors.lastname: Gomes
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Daniel H
authors.initials: DH
authors.lastname: O'Leary
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000473:pathology; D003324:Coronary Artery Disease / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D018487:Ventricular Dysfunction, Left / Q000209:etiology