Cardiac microstructural alterations measured by echocardiography identify sex-specific risk for heart failure.

Autor:	Kwan A; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Demosthenes E; Framingham Heart Study, Framingham, Massachusetts, USA., Salto G; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.; Framingham Heart Study, Framingham, Massachusetts, USA., Ouyang D; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Nguyen T; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Nwabuo CC; Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.; Ronin Institute, Montclair, New Jersey, USA., Luong E; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Hoang A; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Osypiuk E; Framingham Heart Study, Framingham, Massachusetts, USA., Stantchev P; Framingham Heart Study, Framingham, Massachusetts, USA., Kim EH; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Hiremath P; Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA., Li D; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA., Vasan R; Framingham Heart Study, Framingham, Massachusetts, USA.; Departments of Medicine, Biostatistics, and Epidemiology, Boston University Schools of Medicine and Public Health, Boston, Massachusetts, USA., Xanthakis V; Framingham Heart Study, Framingham, Massachusetts, USA.; Departments of Medicine, Biostatistics, and Epidemiology, Boston University Schools of Medicine and Public Health, Boston, Massachusetts, USA., Cheng S; Department of Cardiology, Smidt Heart Institute and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA BioDataCore@cshs.org.; Framingham Heart Study, Framingham, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2022 Oct 28; Vol. 108 (22), pp. 1800-1806. Date of Electronic Publication: 2022 Oct 28.
DOI:	10.1136/heartjnl-2022-320876
Abstrakt:	Objective: Established preclinical imaging assessments of heart failure (HF) risk are based on macrostructural cardiac remodelling. Given that microstructural alterations may also influence HF risk, particularly in women, we examined associations between microstructural alterations and incident HF. Methods: We studied N=2511 adult participants (mean age 65.7±8.8 years, 56% women) of the Framingham Offspring Study who were free of cardiovascular disease at baseline. We employed texture analysis of echocardiography to quantify microstructural alteration, based on the high spectrum signal intensity coefficient (HS-SIC). We examined its relations to incident HF in sex-pooled and sex-specific Cox models accounting for traditional HF risk factors and macrostructural alterations. Results: We observed 94 new HF events over 7.4±1.7 years. Individuals with higher HS-SIC had increased risk for incident HF (HR 1.67 per 1-SD in HS-SIC, 95% CI 1.31 to 2.13; p<0.0001). Adjusting for age and antihypertensive medication use, this association was significant in women (p=0.02) but not men (p=0.78). Adjusting for traditional risk factors (including body mass index, total/high-density lipoprotein cholesterol, blood pressure traits, diabetes and smoking) attenuated the association in women (HR 1.30, p=0.07), with mediation of HF risk by the HS-SIC seen for a majority of these risk factors. However, the HS-SIC association with HF in women remained significant after adjusting for relative wall thickness (representing macrostructure alteration) in addition to these risk factors (HR 1.47, p=0.02). Conclusions: Cardiac microstructural alterations are associated with elevated risk for HF, particularly in women. Microstructural alteration may identify sex-specific pathways by which individuals progress from risk factors to clinical HF. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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