title: Von Willebrand factor and the right ventricle (the MESA-Right Ventricle Study).
abstract: Elevation in plasma activity of von Willebrand factor (vWF) reflects endothelial dysfunction and predicts death in pulmonary arterial hypertension. Higher vWF activity is also associated with a lower right ventricular (RV) ejection fraction in pulmonary arterial hypertension. Little is known about the relation between vWF and RV structure and function in adults without cardiovascular disease. The present investigation included 1,976 participants with magnetic resonance imaging assessment of RV structure and function and measurement of vWF activity from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to estimate the associations between vWF activity and measures of RV structure and function after adjusting for demographics, anthropometrics, smoking, diabetes mellitus, hypertension, and the corresponding left ventricular parameter. The average vWF activity was 140.7 ± 57.2%. Elevated vWF activity was independently associated with lower RV mass, RV end-diastolic volume, and RV stroke volume in models with and without adjustment for the corresponding left ventricular parameter (all p values <0.05). There was no association observed between vWF activity and the RV ejection fraction. In conclusion, higher vWF activity is associated with lower RV mass, RV end-diastolic volume, and RV stroke volume. These associations are independent of common cardiovascular risk factors and left ventricular morphologic changes.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Leary
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bristow
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: Joao A
authors.initials: JA
authors.lastname: Lima
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume; D002318:Cardiovascular Diseases / Q000208:ethnology; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016278:Ventricular Function, Right / Q000502:physiology*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D014841:von Willebrand Factor