Relationship between C-reactive protein levels and regional left ventricular function in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis.
OBJECTIVE
This study sought to investigate the relationship between C-reactive protein (CRP) and regional left ventricular (LV) function in asymptomatic individuals without a history of cardiovascular disease.


BACKGROUND
C-reactive protein is associated with an increased risk for developing cardiovascular disease. However, the relationship between CRP and subclinical LV dysfunction has not been evaluated in asymptomatic individuals.


METHODS
Regional myocardial function was analyzed as peak systolic circumferential shortening strain (Ecc) using the harmonic-phase method by tagged magnetic resonance imaging in 1,164 individuals without symptomatic cardiovascular disease from the MESA (Multi-Ethnic Study of Atherosclerosis) trial (age 66.4 +/- 9.6 years old). Regions were defined by coronary territories: left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). The relationship between log-CRP concentration and Ecc was studied by multivariable linear regression after adjustment for demographic characteristics, risk factors, and therapy (including hormone replacement therapy).


RESULTS
For each region, associations differed by gender with no association of CRP and regional LV function among women. In men, after adjustment, higher log-CRP was significantly associated with lower (absolute) Ecc in the LAD and RCA regions (regression coefficient 0.37 per unit higher log-CRP [95% confidence interval [CI] 0.08 to 0.65] and 0.31 [95% CI 0.02 to 0.59], respectively) and peak systolic Ecc overall (regression coefficient 0.32 [95% CI 0.05 to 0.58]). In the LCX region, the association was weaker (p = 0.06).


CONCLUSIONS
Among individuals without evident heart failure or other cardiovascular disorders, higher CRP was associated with lower systolic myocardial function in all regions in men but not in women. These findings support the role of inflammation and atherosclerosis in incipient myocardial dysfunction. (Multi-Ethnic Study of Atherosclerosis; http://clinicaltrials.gov/ct/show/NCT00005487).
Rosen
Boaz D
BD
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Cushman
Mary
M
Nasir
Khurram
K
Bluemke
David A
DA
Edvardsen
Thor
T
Fernandes
Verônica
V
Lai
Shenghan
S
Tracy
Russell P
RP
Lima
João A C
JA
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000208:ethnology* / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000208:ethnology / Q000503:physiopathology; D044465:White People
D002097:C-Reactive Protein