Chike C Nwabuo1,2, Henrique T Moreira2,3, Henrique D Vasconcellos2, Nathan Mewton2, Anders Opdahl4, Kofo O Ogunyankin5, Bharath Ambale-Venkatesh2, Pamela J Schreiner6, Anderson A C Armstrong2, Cora E Lewis7, David R Jacobs6, Donald Lloyd-Jones5, Samuel S Gidding8, João A C Lima2. 1. Department of Medicine, Harvard Medical School, 330 Mount Auburn St, Cambridge, MA, USA. 2. Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA. 3. Division of Cardiology, Universidade of Sao Paulo, Av. Bandeirantes, 3.900 Monte Alegre, Ribeirão Preto, SP, Brazil. 4. Department of cardiology, Oslo University hospital, Sognsvannsveien 20, Oslo, Norway. 5. Department of Preventive Medicine, Northwestern University, 675 N St Clair St STE 19-100, Chicago, IL, USA. 6. Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Minneapolis, MN, USA. 7. Division of preventive medicine, University of Alabama, 619 19th St, Birmingham, AL, UK. 8. Division of Pediatrics Cardiology, Nemours Cardiac Center, 1600 Rockland Road Wilmington, DE, USA.
Abstract
AIMS: Left ventricular (LV) ejection fraction (LVEF) is an extensively utilized marker of LV function that is often interpreted without recourse to alterations in LV geometry and hypertrophy. LV global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance. We evaluated the prognostic utility of LVGFI from young adulthood into middle age for incident heart failure (HF) and cardiovascular disease (CVD) in comparison to LVEF. METHODS AND RESULTS: Included were 4107 CARDIA participants with echocardiograms in Year-5 (1990-1991). LVGFI was defined as LV stroke volume/LV global volume*100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). Adjusted Cox proportional hazard models were utilized to predict incident HF and CVD outcomes. Mean age of participants was 29.8 ± 3.7 years, 55% female, and 48.7% black. Higher body mass index [beta coefficient (B) = -0.11 standard error (SE) = 0.02, P < 0.001], higher blood pressure (B = -0.04, SE = 0.01, P < 0.01), smoking (B = -0.82, SE = 0.22, P < 0.001), male sex (P < 0.001), and black race (P < 0.001) were associated with worse LVGFI. A total of 207 incident CVD events were observed over the course of 98 035 person-years at risk. Higher LVGFI was associated with HF, hazard ratio (HR) = 0.70, 95% confidence interval (CI) (0.54-0.91), hard CVD HR = 0.83, 95% CI (0.71-0.96), and all CVD HR = 0.83, 95% CI (0.72-0.96). For HF outcomes, Harrell's C-statistic for LVGFI (0.80) was greater than LVEF (0.66). CONCLUSION: LVGFI is a strong, independent predictor of incident HF and CVD that provides incremental prognostic value compared with LVEF. Male sex, black race, obesity, hypertension, and smoking are associated with worse LVGFI in the early adult lifespan. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Left ventricular (LV) ejection fraction (LVEF) is an extensively utilized marker of LV function that is often interpreted without recourse to alterations in LV geometry and hypertrophy. LV global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance. We evaluated the prognostic utility of LVGFI from young adulthood into middle age for incident heart failure (HF) and cardiovascular disease (CVD) in comparison to LVEF. METHODS AND RESULTS: Included were 4107 CARDIA participants with echocardiograms in Year-5 (1990-1991). LVGFI was defined as LV stroke volume/LV global volume*100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). Adjusted Cox proportional hazard models were utilized to predict incident HF and CVD outcomes. Mean age of participants was 29.8 ± 3.7 years, 55% female, and 48.7% black. Higher body mass index [beta coefficient (B) = -0.11 standard error (SE) = 0.02, P < 0.001], higher blood pressure (B = -0.04, SE = 0.01, P < 0.01), smoking (B = -0.82, SE = 0.22, P < 0.001), male sex (P < 0.001), and black race (P < 0.001) were associated with worse LVGFI. A total of 207 incident CVD events were observed over the course of 98 035 person-years at risk. Higher LVGFI was associated with HF, hazard ratio (HR) = 0.70, 95% confidence interval (CI) (0.54-0.91), hard CVD HR = 0.83, 95% CI (0.71-0.96), and all CVD HR = 0.83, 95% CI (0.72-0.96). For HF outcomes, Harrell's C-statistic for LVGFI (0.80) was greater than LVEF (0.66). CONCLUSION: LVGFI is a strong, independent predictor of incident HF and CVD that provides incremental prognostic value compared with LVEF. Male sex, black race, obesity, hypertension, and smoking are associated with worse LVGFI in the early adult lifespan. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Anderson C Armstrong; David R Jacobs; Samuel S Gidding; Laura A Colangelo; Ola Gjesdal; Cora E Lewis; Kirsten Bibbins-Domingo; Stephen Sidney; Pamela J Schreiner; O D Williams; David C Goff; Kiang Liu; Joao A C Lima Journal: Int J Cardiol Date: 2014-01-16 Impact factor: 4.164
Authors: Chike C Nwabuo; Henrique T Moreira; Henrique D Vasconcellos; Bharath Ambale-Venkatesh; Kihei Yoneyama; Yoshiaki Ohyama; Ravi K Sharma; Anderson C Armstrong; Mohammed R Ostovaneh; Cora E Lewis; Kiang Liu; Pamela J Schreiner; Kofo O Ogunyankin; Samuel S Gidding; João A C Lima Journal: J Am Soc Echocardiogr Date: 2017-09-15 Impact factor: 5.251
Authors: Emelia J Benjamin; Salim S Virani; Clifton W Callaway; Alanna M Chamberlain; Alexander R Chang; Susan Cheng; Stephanie E Chiuve; Mary Cushman; Francesca N Delling; Rajat Deo; Sarah D de Ferranti; Jane F Ferguson; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Pamela L Lutsey; Jason S Mackey; David B Matchar; Kunihiro Matsushita; Michael E Mussolino; Khurram Nasir; Martin O'Flaherty; Latha P Palaniappan; Ambarish Pandey; Dilip K Pandey; Mathew J Reeves; Matthew D Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Uchechukwu K A Sampson; Gary M Satou; Svati H Shah; Nicole L Spartano; David L Tirschwell; Connie W Tsao; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2018-01-31 Impact factor: 29.690
Authors: Anderson C Armstrong; Erin P Ricketts; Christopher Cox; Paul Adler; Alexander Arynchyn; Kiang Liu; Ellen Stengel; Stephen Sidney; Cora E Lewis; Pamela J Schreiner; James M Shikany; Kimberly Keck; Jamie Merlo; Samuel S Gidding; João A C Lima Journal: Echocardiography Date: 2014-11-09 Impact factor: 1.724
Authors: Bharath Ambale-Venkatesh; Kihei Yoneyama; Ravi K Sharma; Yoshiaki Ohyama; Colin O Wu; Gregory L Burke; Steven Shea; Antoinette S Gomes; Alistair A Young; David A Bluemke; João Ac Lima Journal: Heart Date: 2016-09-30 Impact factor: 5.994
Authors: David A Bluemke; Richard A Kronmal; João A C Lima; Kiang Liu; Jean Olson; Gregory L Burke; Aaron R Folsom Journal: J Am Coll Cardiol Date: 2008-12-16 Impact factor: 24.094
Authors: Casper N Bang; Eva Gerdts; Gerard P Aurigemma; Kurt Boman; Giovanni de Simone; Björn Dahlöf; Lars Køber; Kristian Wachtell; Richard B Devereux Journal: Circ Cardiovasc Imaging Date: 2014-04-10 Impact factor: 7.792
Authors: Anderson C Armstrong; Samuel S Gidding; Laura A Colangelo; Satoru Kishi; Kiang Liu; Stephen Sidney; Suma Konety; Cora E Lewis; Luís C L Correia; Joao A C Lima Journal: BMJ Open Date: 2014-01-02 Impact factor: 3.006
Authors: Chike C Nwabuo; Yuichiro Yano; Henrique T Moreira; Duke Appiah; Henrique D Vasconcellos; Queen N Aghaji; Anthony Viera; Jamal S Rana; Ravi V Shah; Venkatesh L Murthy; Norrina B Allen; Pamela J Schreiner; Donald M Lloyd-Jones; João A C Lima Journal: JAMA Cardiol Date: 2020-07-01 Impact factor: 14.676
Authors: Chike C Nwabuo; Aisha S Betoko; Jared P Reis; Henrique T Moreira; Henrique D Vasconcellos; Eliseo Guallar; Christopher Cox; Stephen Sidney; Bharath Ambale-Venkatesh; Cora E Lewis; Pamela J Schreiner; Donald Lloyd-Jones; Catarina I Kiefe; Samuel S Gidding; João A C Lima Journal: ESC Heart Fail Date: 2020-05-25
Authors: Hieu T Ta; Paul J Critser; Tarek Alsaied; Joshua Germann; Adam W Powell; Andrew N Redington; Justin T Tretter Journal: J Am Heart Assoc Date: 2020-07-07 Impact factor: 5.501
Authors: Jack Rubinstein; Jessica G Woo; Anastacia M Garcia; Tarek Alsaied; Jia Li; Per Kristian Lunde; Ryan A Moore; Martin Laasmaa; Amanda Sammons; Wayne A Mays; Shelley D Miyamoto; William E Louch; Gruschen R Veldtman Journal: Pediatr Cardiol Date: 2020-08-07 Impact factor: 1.655
Authors: Chike C Nwabuo; Meredith Duncan; Vanessa Xanthakis; Linda R Peterson; Gary F Mitchell; David McManus; Susan Cheng; Ramachandran S Vasan Journal: J Am Heart Assoc Date: 2019-09-24 Impact factor: 5.501