title: Left ventricular area on non-contrast cardiac computed tomography as a predictor of incident heart failure - The Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  The use of non-contrast cardiac computed tomography measurements to predict heart failure (HF) has not been studied. In the present study we evaluated the prognostic value of left ventricular area adjusted for the body surface area (LVA-BSA) measured by non-contrast cardiac CT to predict incident HF and cardiovascular disease (CVD) events.
  
  
  METHODS
  We studied left ventricular dimensions and calculated LVA-BSA in 6781 participants of the MESA study (mean age: was 62 ± 10 years, 53% females; 62% non-white) free from prior HF who underwent non-contrast cardiac CT to evaluate the coronary artery calcium score (CAC) at baseline and were followed up for a median of 10.2 years.
  
  
  RESULTS
  During follow up, 237 (3.5%) incident HF and 475 (7.0%) CVD events occurred. After adjustment for clinical variables and CAC, LVA-BSA was significantly associated with incident HF (hazard ratio [HR]: 1.10 per 100 mm2/m2, p < 0.001) and CVD events (HR: 1.07 per 100 mm2/m2, p < 0.001). The area under the ROC curve for the prediction of incident HF improved from 0.787 on a model including only risk factors to 0.798 when CAC was added (p = 0.02), and to 0.816 with the additional inclusion of LVA-BSA (p = 0.007). Similar improvements for the prediction of CVD events were noted.
  
  
  CONCLUSIONS
  In an ethnically diverse population of asymptomatic individuals free from baseline CVD or HF, the left ventricular area measured by non-contrast cardiac CT is a strong predictor of incident HF events beyond traditional risk factors and CAC score.
authors: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; Preventive Medicine Center Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors: Marcio Sommer
authors: MS
authors: Bittencourt
authors: Non-Invasive Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
authors: Ron
authors: R
authors: Blankstein
authors: Division of Cardiology, Los Angeles Biomedical Research Institute at Harbour-UCLA, Torrance, CA, United States.
authors: Songshou
authors: S
authors: Mao
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, United States.
authors: Juan J
authors: JJ
authors: Rivera
authors: Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC, United States.
authors: Alain G
authors: AG
authors: Bertoni
authors: Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States.
authors: Leslee J
authors: LJ
authors: Shaw
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, United States.
authors: Roger S
authors: RS
authors: Blumenthal
authors: Division of Cardiology, Los Angeles Biomedical Research Institute at Harbour-UCLA, Torrance, CA, United States.
authors: Matthew J
authors: MJ
authors: Budoff
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, United States; Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL, United States; Miami Cardiac & Vascular Institute (MCVI), Baptist Health South Florida, Miami, FL, United States; Department of Medicine Herbert Wertheim College of Medicine & Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States. Electronic address: KhurramN@baptisthealth.net.
authors: Khurram
authors: K
authors: Nasir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000503:physiopathology
keywords: Heart failure; Left ventricle size; Non-contrast cardiac computed tomography; Prognosis