Stephen T Broughton1, Wesley T O'Neal2, Mouaz Al-Mallah3, David A Bluemke4, Susan R Heckbert5, Joao A C Lima6, Elsayed Z Soliman7. 1. Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. 2. Deparment of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: wesley.oneal@emory.edu. 3. Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA; Department of Cardiac Imaging, King Abdul Aziz Cardiac Center, Riyadh, Saudi Arabia. 4. Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA. 5. Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. 6. Department of Medicine, Division of Cardiology, Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. 7. Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Abstract
BACKGROUND: It is unknown if normal findings on noninvasive cardiac assessment are able to identify individuals who are low risk for developing heart failure (HF). METHODS: We examined if normal findings on the routine electrocardiogram (ECG) and cardiac magnetic resonance imaging (MRI) were able to identify individuals who are low risk for developing HF in 4986 (mean age=62±10years; 52% women; 39% White; 13% Chinese-American; 26% Black; 22% Hispanic) participants from the Multi-Ethnic Study of Atherosclerosis who were free of clinically apparent HF at baseline. A normal ECG was defined as the absence of major abnormalities by Minnesota Code Classification, and a normal MRI was defined as absence of structural abnormalities and systolic dysfunction. RESULTS: There were 3988 (80%) participants with normal findings at baseline on both ECG and MRI, 894 (18%) who had either a normal ECG or normal MRI, and 104 (2%) who had abnormal findings on ECG and MRI. Over a median follow-up of 12.2years, 177 (3.6%) HF events occurred. Normal ECG (HR=0.41, 95%CI=0.29, 0.56) and MRI (HR=0.32, 95%CI=0.23, 0.45) were each associated with lower risk of HF compared with abnormal, and their combination was associated with a lower HF risk (HR=0.13, 95%CI=0.08, 0.21) than either in isolation. CONCLUSION: Normal findings on noninvasive cardiac assessment identify individuals in whom the risk of HF is low. Further studies are needed to explore the utility of this low-risk profile in HF prevention strategies.
BACKGROUND: It is unknown if normal findings on noninvasive cardiac assessment are able to identify individuals who are low risk for developing heart failure (HF). METHODS: We examined if normal findings on the routine electrocardiogram (ECG) and cardiac magnetic resonance imaging (MRI) were able to identify individuals who are low risk for developing HF in 4986 (mean age=62±10years; 52% women; 39% White; 13% Chinese-American; 26% Black; 22% Hispanic) participants from the Multi-Ethnic Study of Atherosclerosis who were free of clinically apparent HF at baseline. A normal ECG was defined as the absence of major abnormalities by Minnesota Code Classification, and a normal MRI was defined as absence of structural abnormalities and systolic dysfunction. RESULTS: There were 3988 (80%) participants with normal findings at baseline on both ECG and MRI, 894 (18%) who had either a normal ECG or normal MRI, and 104 (2%) who had abnormal findings on ECG and MRI. Over a median follow-up of 12.2years, 177 (3.6%) HF events occurred. Normal ECG (HR=0.41, 95%CI=0.29, 0.56) and MRI (HR=0.32, 95%CI=0.23, 0.45) were each associated with lower risk of HF compared with abnormal, and their combination was associated with a lower HF risk (HR=0.13, 95%CI=0.08, 0.21) than either in isolation. CONCLUSION: Normal findings on noninvasive cardiac assessment identify individuals in whom the risk of HF is low. Further studies are needed to explore the utility of this low-risk profile in HF prevention strategies.
Authors: Michael J Blaha; Miguel Cainzos-Achirica; Philip Greenland; John W McEvoy; Ron Blankstein; Matthew J Budoff; Zeina Dardari; Christopher T Sibley; Gregory L Burke; Richard A Kronmal; Moyses Szklo; Roger S Blumenthal; Khurram Nasir Journal: Circulation Date: 2016-01-22 Impact factor: 29.690
Authors: J Stamler; R Stamler; J D Neaton; D Wentworth; M L Daviglus; D Garside; A R Dyer; K Liu; P Greenland Journal: JAMA Date: 1999-12-01 Impact factor: 56.272
Authors: J S Gottdiener; A M Arnold; G P Aurigemma; J F Polak; R P Tracy; D W Kitzman; J M Gardin; J E Rutledge; R C Boineau Journal: J Am Coll Cardiol Date: 2000-05 Impact factor: 24.094
Authors: Christy L Avery; Laura R Loehr; Christopher Baggett; Patricia P Chang; Anna M Kucharska-Newton; Kunihiro Matsushita; Wayne D Rosamond; Gerardo Heiss Journal: J Am Coll Cardiol Date: 2012-09-26 Impact factor: 24.094
Authors: Hossein Bahrami; Richard Kronmal; David A Bluemke; Jean Olson; Steven Shea; Kiang Liu; Gregory L Burke; João A C Lima Journal: Arch Intern Med Date: 2008-10-27
Authors: Pentti M Rautaharju; Ron J Prineas; Joy Wood; Zhu-Ming Zhang; Richard Crow; Gerardo Heiss Journal: Am J Cardiol Date: 2007-08-22 Impact factor: 2.778
Authors: Baris Gencer; Javed Butler; Douglas C Bauer; Reto Auer; Andreas Kalogeropoulos; Pedro Marques-Vidal; William B Applegate; Suzanne Satterfield; Tamara Harris; Anne Newman; Eric Vittinghoff; Nicolas Rodondi Journal: Am Heart J Date: 2014-04-05 Impact factor: 4.749
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Leonard Ilkhanoff; Kiang Liu; Hongyan Ning; Saman Nazarian; David A Bluemke; Elsayed Z Soliman; Donald M Lloyd-Jones Journal: Eur J Heart Fail Date: 2012-07-12 Impact factor: 15.534
Authors: Gerald S Bloomfield; Isabelle R Weir; Heather J Ribaudo; Kathleen V Fitch; Carl J Fichtenbaum; Laura E Moran; Roger Bedimo; Christopher de Filippi; Caryn G Morse; Jonathan Piccini; Markella V Zanni; Michael T Lu; Udo Hoffmann; Steven K Grinspoon; Pamela S Douglas Journal: J Acquir Immune Defic Syndr Date: 2022-03-01 Impact factor: 3.771