Association of computed tomography-derived left ventricular size with major cardiovascular events in the general population: The Heinz Nixdorf recall study

作者：Dykun Iryna; Geisel Marie H; Kaelsch Hagen; Lehmann Nils; Bauer Marcus; Moebus Susanne; Joeckel Karl Heinz; Moehlenkamp Stefan; Erbel Raimund; Mahabadi Amir A^*

来源：Atherosclerosis, 2015, 240(1): 46-52.

DOI：10.1016/j.atherosclerosis.2015.02.050

• Prevention
• Coronary artery calcification
• Left ventricle
• Epidemiology
• Computed tomography
• Heinz Nixdorf recall study

Objective: To investigate the relationship between LV size as determined by non-contrast enhanced cardiac CT with incident cardiovascular disease in the general population free of clinical cardiovascular disease.
Methods: LV axial area was quantified from non-contrast CT in axial, end-diastolic images at a mid-ventricular slice in participants from the population-based Heinz Nixdorf recall study, free of cardiovascular disease (n = 3926, 59 +/- 8years, 53% female). LV size index (LVI) was defined as the quotient of LV area and body surface area. Major CV events (coronary events, stroke, CV death) were assessed during follow-up. Association of LVI with events was assessed using Cox regression analysis in unadjusted and multivariable adjusted models.
Results: During 8.0 +/- 1.5years of follow-up, 219 subjects developed a major CV event. Those with events had larger LVI at baseline (2258 +/- 352 vs. 2149 +/- 276 mm(2)/m(2), p < 0.0001). In univariate analysis, increase of LVI by 1 standard deviation was associated with 40% higher risk of events (HR(95% CI): 1.41(1.26 -1.59), p < 0.0001). Associations remained statistically significant after adjustment for CV risk factors (1.24(1.10-1.40), p = 0.0007) and when further adjusting for CAC (1.21(1.07-1.37), p = 0.003). There was a trend towards stronger association for subjects with low CAC-score (CAC<100:1.41(1.16-1.71), p = 0.0005, CAC >= 100:1.24(1.06-1.44), p = 0.006) in univariate analysis which persisted after multivariable adjustment (CAC<100:1.41(1.14-1.73), p = 0.001, CAC >= 100:1.12(0.96-1.31), p = 0.16).
Conclusion: CT-derived LV size is associated with incident major CV events independent of traditional risk factors and CAC-score in a population-based cohort and may improve the prediction of hard events especially in subjects with low CAC-scores.

• 出版日期2015-5
• 单位河北医科大学