title: Regional left ventricular systolic function and the right ventricle: the multi-ethnic study of atherosclerosis right ventricle study.
abstract: BACKGROUND
  Dysfunction of the interventricular septum has been implicated in right ventricular (RV) failure. However, little is known about the relationship between ventricular septal and RV function in patients without clinical cardiovascular disease. We hypothesized that better septal function would be associated with higher RV ejection fraction and lower RV mass and volume by cardiac MRI.
  
  
  METHODS
  In the Multi-Ethnic Study of Atherosclerosis (MESA), cardiac MRI was performed on community-based participants without clinical cardiovascular disease. Images were analyzed by the harmonic phase method to measure peak circumferential systolic midventricular strain for each wall (anterior, lateral, inferior, and septal). Multivariable linear regression and generalized additive models were used to assess the relationship between septal strain and RV morphology.
  
  
  RESULTS
  There were 917 participants (45.7% women) with a mean age of 65.7 years. Better septal function was associated with higher RV ejection fraction in a nonlinear fashion after adjustment for all covariates (P = .03). There appeared to be a threshold effect for the contribution of septal strain to RV systolic function, with an almost linear decrement in RV ejection fraction with septal strain from -18% to -10%. Septal function was not related to RV mass or volume.
  
  
  CONCLUSIONS
  Interventricular septal function was linked to RV systolic function independent of other left ventricular regions, even in individuals without clinical cardiovascular disease. This finding confirms animal and human research suggesting the importance of septal function to the right ventricle and implies that changes in septal function could herald RV dysfunction.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT00005487; URL: www.clinicaltrials.gov.
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Dibble
authors.affiliation: Department of Medicine Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Joao A C
authors.initials: JAC
authors.lastname: Lima
authors.affiliation: Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, Bethesda, MD.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Penn Cardiovascular Institute, University of Pennsylvania School of Medicine Philadelphia, PA.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
authors.affiliation: Department of Medicine Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Harjit
authors.initials: H
authors.lastname: Chahal
authors.affiliation: Department of Medicine, Anschutz Medical Center, University of Colorado Denver, Aurora, CO.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bristow
authors.affiliation: Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Penn Cardiovascular Institute, University of Pennsylvania School of Medicine Philadelphia, PA.
authors.forename: Victor A
authors.initials: VA
authors.lastname: Ferrari
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Propert
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia, PA; Penn Cardiovascular Institute, University of Pennsylvania School of Medicine Philadelphia, PA. Electronic address: kawut@mail.med.upenn.edu.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D050197:Atherosclerosis / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D006346:Heart Septum / Q000503:physiopathology*; D006630:Hispanic or Latino; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000208:ethnology / Q000503:physiopathology*; D016277:Ventricular Function, Left; D044465:White People