title: Left ventricular mechanical function: clinical correlates, heritability, and association with parental heart failure.
abstract: OBJECTIVE
  Non-invasive measures of cardiac mechanical function may have the potential to serve as markers of risk for heart failure; however, limited data exist regarding clinical correlates and heritability of these measures in the community.
  
  
  RESULTS
  We used speckle-tracking echocardiography to assess LV strain and synchrony in the Framingham Offspring Study (n = 2816; mean age 67 years, 54% women). In multivariable regression analyses, male gender (vs. female, P < 0.001), higher heart rate (P < 0.0001), and presence of cardiovascular disease (P < 0.001) were associated with worse global peak strains across all planes analysed (longitudinal, transverse, circumferential, and radial). Higher diastolic blood pressure and diabetes were associated with worse longitudinal strain (P < 0.01), and greater body mass index was associated with worse radial strain (P = 0.0004). Overall, however, clinical correlates accounted for only 4-19% of the variation in measures of LV mechanical function. Select measures of LV strain were heritable: longitudinal strain (h(2)  = 16%, P = 0.002), transverse strain (h(2)  = 15%, P = 0.006), and circumferential strain (h(2)  = 30%, P < 0.0001). Furthermore, in a subset of 1437 participants with parental data available, parental heart failure was associated with worse circumferential strain in the offspring free of heart failure (P = 0.01).
  
  
  CONCLUSIONS
  Our investigation in a large community-based sample identified heritablity and clinical correlates of LV mechanical function, and highlighted an association of parental heart failure with worse global circumferential strain in offspring.
authors.affiliation: Framingham Heart Study, Framingham, MA, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McCabe
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Chen
authors.forename: Ewa
authors.initials: E
authors.lastname: Osypiuk
authors.forename: Birgitta T
authors.initials: BT
authors.lastname: Lehman
authors.forename: Plamen
authors.initials: P
authors.lastname: Stantchev
authors.forename: Jayashri
authors.initials: J
authors.lastname: Aragam
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000235:genetics*; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010290:Parents; D012737:Sex Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D016277:Ventricular Function, Left / Q000235:genetics* / Q000502:physiology
keywords: Heart failure; Heritability; Myocardial strain