title: High-sensitivity C-reactive protein as an independent predictor of progressive myocardial functional deterioration: the multiethnic study of atherosclerosis.
abstract: BACKGROUND
  Systemic inflammation has been linked to the development of heart failure in population studies including Multi-Ethnic Study of Atherosclerosis (MESA), but little evidence exists regarding potential mechanism of this relationship. In this study, we used longitudinal magnetic resonance imaging follow-up analysis to examine whether C-reactive protein (CRP) levels relate to progressive myocardial functional deterioration as a potential mechanism of incident heart failure.
  
  
  METHODS
  Regional myocardial functional data from MESA participants who had baseline CRP measurement and also underwent tagged cardiac magnetic resonance imaging both at baseline and at 5-year follow-up were analyzed. Left ventricular midwall and midslice peak circumferential strain (Ecc), of which a more negative value denotes stronger regional myocardial function, was measured. Circumferential strain change was calculated as the difference between baseline and follow-up Ecc.
  
  
  RESULTS
  During the follow-up period, participants (n = 785) with elevated CRP experienced a decrease in strain, independent of age, gender, and ethnicity (B = 0.081, ∆Ecc change per 1 mg/L CRP change, 95% CI 0.036-0.126, P < .001, model 1) and, additionally, beyond systolic blood pressure, heart rate, diabetes, smoking status, body mass index, current medication, and glomerular filtration rate (B = 0.099, 0.052-0.145, P < .001, model 2). The relationship remained statistically significant after further adjustment for left ventricular mass, coronary calcium score, and interim clinical coronary events (B = 0.098, 0.049-0.147, P < .001, model 3).
  
  
  CONCLUSIONS
  Higher CRP levels are related to progressive myocardial functional deterioration independent of subclinical atherosclerosis and clinical coronary events in asymptomatic individuals without previous history of heart disease.
authors.affiliation: Johns Hopkins University, Baltimore, MD 21287, USA.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Yan
authors.forename: Veronica R S
authors.initials: VR
authors.lastname: Fernandes
authors.forename: Anders
authors.initials: A
authors.lastname: Opdahl
authors.forename: Antoinette S
authors.initials: AS
authors.lastname: Gomes
authors.forename: Andre L C
authors.initials: AL
authors.lastname: Almeida
authors.forename: Colin O
authors.initials: CO
authors.lastname: Wu
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Carr
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006321:Heart / Q000503:physiopathology; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein