Rationale and design of a multicenter echocardiographic study to assess the relationship between cardiac structure and function and heart failure risk in a biracial cohort of community-dwelling elderly persons: the Atherosclerosis Risk in Communities study.
BACKGROUND
Heart failure is an important public health concern, particularly among persons>65 years of age. Women and blacks are critically understudied populations that carry a sizeable portion of the heart failure burden. Limited normative and prognostic data exist on measures of cardiac structure, diastolic function, and novel measures of systolic deformation in older adults living in the community.


RESULTS
The Atherosclerosis Risk in Communities (ARIC) study is a large, predominantly biracial, National Heart, Lung, and Blood Institute-sponsored epidemiological cohort study. Between 2011 and 2013, ≈6000 surviving participants, now in their seventh to ninth decade of life, are expected to return for a fifth study visit during which comprehensive 2-dimensional, Doppler, tissue Doppler, and speckle-tracking echocardiography will be performed uniformly in all cohort clinic visit participants. The following objectives will be addressed: (1) to characterize cardiac structural and functional abnormalities among the elderly and to determine how they differ by sex and race/ethnicity, (2) to determine the relationship between ventricular and vascular abnormalities, and (3) to prospectively examine the extent to which these noninvasive measures associate with incident heart failure.


CONCLUSIONS
We describe the design, imaging acquisition and analysis methods, and quality assurance metrics for echocardiography in visit 5 of the ARIC cohort. A better understanding of the differences in cardiac structure and function through the spectrum of heart failure stages in elderly persons generally, and between sexes and racial/ethnic groups specifically, will deepen our understanding of the pathophysiology driving heart failure progression in these at-risk populations and may inform novel prevention or therapeutic strategies.
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
Amil M
AM
Shah
Susan
S
Cheng
Hicham
H
Skali
Justina
J
Wu
Judy R
JR
Mangion
Dalane
D
Kitzman
Kunihiro
K
Matsushita
Suma
S
Konety
Kenneth R
KR
Butler
Ervin R
ER
Fox
Nakela
N
Cook
Hanyu
H
Ni
Josef
J
Coresh
Thomas H
TH
Mosley
Gerardo
G
Heiss
Aaron R
AR
Folsom
Scott D
SD
Solomon
D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000208:ethnology* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D054555:National Heart, Lung, and Blood Institute (U.S.); D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D044465:White People / Q000706:statistics & numerical data*
aging; echocardiography; epidemiology