Adverse Left Ventricular Remodeling and Age Assessed with Cardiac MR Imaging: The Multi-Ethnic Study of Atherosclerosis.
OBJECTIVE
To evaluate age-related left ventricular (LV) remodeling during longitudinal observation of a large cohort of asymptomatic individuals who were free of clinical cardiovascular disease at baseline.


METHODS
The applicable institutional review boards approved this study, and all participants gave informed consent. Cardiac magnetic resonance (MR) imaging was used to identify longitudinal changes in LV structure and function in 2935 participants who underwent baseline and follow-up cardiac MR imaging in the Multi-Ethnic Study of Atherosclerosis. Participants were free of clinical cardiovascular disease at baseline. Participants who experienced an incident coronary heart disease event were excluded. Data were analyzed with multivariable mixed-effects regression models in which the outcome was cardiac MR imaging measurement, and the covariates included follow-up time and cardiac risk factors.


RESULTS
Participants were aged 54-94 years at follow-up, and 53% of the participants were women. Median time between baseline and follow-up cardiac MR imaging was 9.4 years. Over this period, LV mass increased in men and decreased slightly in women (8.0 and -1.6 g per decade, respectively; P < .001). In both men and women, LV end-diastolic volume decreased (-9.8 and -13.3 mL per decade, respectively; P < .001), stroke volume decreased (-8.8 and -8.6 mL per decade, respectively; P < .001), and mass-to-volume ratio increased (0.14 and 0.11 g/mL per decade, respectively; P < .001). Change in LV mass was positively associated with systolic blood pressure and body mass index and negatively associated with treated hypertension and high-density lipoprotein cholesterol level. In men, the longitudinal LV mass increase was in contrast to a cross-sectional pattern of LV mass decrease.


CONCLUSIONS
As patients age, the LV responds differently in its mass and volume between men and women, although both men and women experience increased concentric LV remodeling with age. In men, the opposition of longitudinal and cross-sectional changes in LV mass highlights the importance of longitudinal study.
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
John
J
Eng
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Robyn L
RL
McClelland
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Antoinette S
AS
Gomes
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
W Gregory
WG
Hundley
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Susan
S
Cheng
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Colin O
CO
Wu
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
J Jeffrey
JJ
Carr
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Steven
S
Shea
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
David A
DA
Bluemke
From the Russell H. Morgan Department of Radiology and Radiological Science (J.E.) and Division of Cardiology, Department of Medicine (J.A.C.L.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Department of Biostatistics, University of Washington, Seattle, Wash (R.L.M.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Division of Cardiology, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (W.G.H.); Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass (S.C.); Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Md (C.O.W.); Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (J.J.C.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); and Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (D.A.B.).
Joao A C
JA
Lima
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D055424:Cardiac-Gated Imaging Techniques; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D020257:Ventricular Remodeling