Regional Dysfunction by MRI in Incident Heart Failure

Summary

Principal Investigator: Joao A C Lima
Abstract: Heart failure is one of the most important causes of morbidity and mortality in the United States and strategies to reduce its burden to society require a greater understanding of human myocardial dysfunction and its natural history. The most common etiology of heart failure in the U.S. is coronary artery disease and thus the earliest manifestations of systolic myocardial dysfunction in humans are likely to be regional in nature. However, a large proportion of patients with heart failure have diastolic dysfunction with preserved systolic function. In these, hypertension and aging are established pre-disposing factors but early precursors of this condition remain unknown. Previous longitudinal studies aimed at elucidating the pathophysiology of heart failure were not structured to measure regional alterations of systolic and/or diastolic function directly. This study was specifically designed to fill this knowledge gap by obtaining MRI tagging studies in 2,126 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) at baseline for the purpose of detecting the earliest manifestations of systolic and diastolic myocardial dysfunction in humans. In this continuation study, we propose to repeat MRI tagging in 1,300 of those participants to define the natural history of changes in regional and global systolic and diastolic function relative to the development and progression of sub-clinical disease and risk factors over 3-5 years. In addition, we will also examine whether changes in regional function predict the development of global LV dysfunction, symptomatic congestive heart failure and death. Baseline cross-sectional analyses will be used to define markers and risk factors of interest. Pilot studies on the magnitude of regional function change from 60 particpants over 1-2 years indicate that the proposed studies have ample power to test all specific aims. The same MRI protocol and analytical tools will be used to assure precise comparisons with baseline data. We expect to define the natural history of myocardial dysfunction in humans of different ethnicities and different exposures to risk factors. We anticipate that these studies will permit the identification of the earliest precursors of heart failure by demonstrating crucial relationships between sub-clinical disease and incident regional myocardial dysfunction, and between regional dysfunction and incident symptomatic failure. These findings will be pivotal to the design of future strategies to forestall progressive myocardial dysfunction and prevent the development of heart failure.
Funding Period: 2000-12-01 - 2010-01-31
more information: NIH RePORT

Top Publications

  1. pmc Interstitial fibrosis, left ventricular remodeling, and myocardial mechanical behavior in a population-based multiethnic cohort: the Multi-Ethnic Study of Atherosclerosis (MESA) study
    Sirisha Donekal
    Department of Cardiology, Johns Hopkins University, Baltimore, MD
    Circ Cardiovasc Imaging 7:292-302. 2014
  2. pmc High-sensitivity C-reactive protein as an independent predictor of progressive myocardial functional deterioration: the multiethnic study of atherosclerosis
    Eui Young Choi
    Johns Hopkins University, Baltimore, MD 21287, USA
    Am Heart J 164:251-8. 2012
  3. pmc N-terminal pro-B-type natriuretic peptide, left ventricular mass, and incident heart failure: Multi-Ethnic Study of Atherosclerosis
    Eui Young Choi
    Johns Hopkins University, Baltimore, MD, USA
    Circ Heart Fail 5:727-34. 2012
  4. pmc Left ventricular mass and hypertrophy by echocardiography and cardiac magnetic resonance: the multi-ethnic study of atherosclerosis
    Anderson C Armstrong
    Division of Cardiology, Johns Hopkins University, Baltimore, Maryland School of Medicine, University of São Francisco Valley, Petrolina, Pernambuco, Brazil
    Echocardiography 31:12-20. 2014
  5. pmc Predictors of inaccurate coronary arterial stenosis assessment by CT angiography
    Raymond T Yan
    Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland
    JACC Cardiovasc Imaging 6:963-72. 2013
  6. pmc The prospective association of Chlamydia pneumoniae and four other pathogens with development of coronary artery calcium: the multi-ethnic study of atherosclerosis (MESA)
    Babray Laek
    Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA Netherlands Institute for Health Sciences, Erasmus University, Dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands Electronic address
    Atherosclerosis 230:268-74. 2013
  7. pmc Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis
    Andrew T Yan
    Division of Cardiology, St Michael s Hospital, University of Toronto, Toronto, ON, Canada
    Eur Heart J 31:875-82. 2010
  8. pmc Fibrinogen and left ventricular myocardial systolic function: The Multi-Ethnic Study of Atherosclerosis (MESA)
    Raymond T Yan
    Johns Hopkins Hospital, Baltimore, MD 21287 0409, USA
    Am Heart J 160:479-86. 2010
  9. pmc Racial and ethnic differences in subclinical myocardial function: the Multi-Ethnic Study of Atherosclerosis
    Verônica Rolim S Fernandes
    Division of Cardiology, The Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287, USA
    Heart 97:405-10. 2011
  10. pmc Regional left ventricular systolic function and the right ventricle: the multi-ethnic study of atherosclerosis right ventricle study
    Christopher T Dibble
    University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Chest 140:310-6. 2011

Scientific Experts

  • Joao A C Lima
  • Li Pan
  • Ilan Gottlieb
  • David A Bluemke
  • Boaz D Rosen
  • Raymond T Yan
  • Thor Edvardsen
  • Julie M Miller
  • Khurram Nasir
  • Hossein Bahrami
  • Robyn L McClelland
  • Armin Arbab-Zadeh
  • Verônica Rolim S Fernandes
  • Melvin E Clouse
  • Hiroyuki Niinuma
  • Carlos E Rochitte
  • Shenghan Lai
  • Veronica Fernandes
  • Veronica R S Fernandes
  • Eui Young Choi
  • Marc Dewey
  • Michael Jerosch-Herold
  • Mary Cushman
  • John Hoe
  • Narinder Paul
  • Susan Cheng
  • Kiang Liu
  • Colin O Wu
  • Jeffrey Brinker
  • Andrew T Yan
  • Christopher Cox
  • David E Bush
  • Albert C Lardo
  • Albert de Roos
  • Richard A Kronmal
  • Richard Kronmal
  • Benilton Carvalho
  • Steven Shea
  • Anderson C Armstrong
  • Marcelo Nacif
  • Sirisha Donekal
  • Babray Laek
  • Kihei Yoneyama
  • Antoinette S Gomes
  • Colin Wu
  • Anders Opdahl
  • Andre L C Almeida
  • Russell Tracy
  • Christopher T Dibble
  • Andrea L Vavere
  • Moyses Szklo
  • Jeffrey J Carr
  • Joanna J Wykrzykowska
  • Edward P Shapiro
  • W Gregory Hundley
  • Alban Redheuil
  • Robyn McClelland
  • Russell P Tracy
  • Antoinette Gomes
  • Gregory Burke
  • Jeffery Brinker
  • Shantanu Sinha
  • Donna K Arnett
  • Robert Detrano
  • Daniel H O'Leary
  • Joseph F Polak
  • Aaron R Folsom
  • Nael F Osman
  • Ernesto Castillo
  • Clerio F Azevedo
  • Bharath A Venkatesh
  • Ola Gjesdal
  • Yuan Chang Liu
  • Chia Ying Liu
  • Lyndia Brumback
  • Andre Almeida
  • Michael Y Tsai
  • Kunihiro Matsushita
  • Jingzhong Ding
  • Philip Greenland
  • David Siscovick
  • Lori B Daniels
  • Alan Maisel
  • Aditya Jain
  • Michael H Criqui
  • Christine Darwin
  • Steven M Kawut
  • Harjit Chahal
  • R Graham Barr
  • Victor A Ferrari

Detail Information

Publications36

  1. pmc Interstitial fibrosis, left ventricular remodeling, and myocardial mechanical behavior in a population-based multiethnic cohort: the Multi-Ethnic Study of Atherosclerosis (MESA) study
    Sirisha Donekal
    Department of Cardiology, Johns Hopkins University, Baltimore, MD
    Circ Cardiovasc Imaging 7:292-302. 2014
    ..We assessed sex-associated differences in the relation of ECE to left ventricular (LV) remodeling and myocardial systolic and diastolic deformation in a large community-based multiethnic population...
  2. pmc High-sensitivity C-reactive protein as an independent predictor of progressive myocardial functional deterioration: the multiethnic study of atherosclerosis
    Eui Young Choi
    Johns Hopkins University, Baltimore, MD 21287, USA
    Am Heart J 164:251-8. 2012
    ....
  3. pmc N-terminal pro-B-type natriuretic peptide, left ventricular mass, and incident heart failure: Multi-Ethnic Study of Atherosclerosis
    Eui Young Choi
    Johns Hopkins University, Baltimore, MD, USA
    Circ Heart Fail 5:727-34. 2012
    ..We studied the associations of plasma NT-proBNP and magnetic resonance imaging defined LV mass index with incident HF in an asymptomatic multi-ethnic population...
  4. pmc Left ventricular mass and hypertrophy by echocardiography and cardiac magnetic resonance: the multi-ethnic study of atherosclerosis
    Anderson C Armstrong
    Division of Cardiology, Johns Hopkins University, Baltimore, Maryland School of Medicine, University of São Francisco Valley, Petrolina, Pernambuco, Brazil
    Echocardiography 31:12-20. 2014
    ..We also compare indexing methods within and between imaging modalities for classification of LVH and cardiovascular risk...
  5. pmc Predictors of inaccurate coronary arterial stenosis assessment by CT angiography
    Raymond T Yan
    Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland
    JACC Cardiovasc Imaging 6:963-72. 2013
    ....
  6. pmc The prospective association of Chlamydia pneumoniae and four other pathogens with development of coronary artery calcium: the multi-ethnic study of atherosclerosis (MESA)
    Babray Laek
    Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA Netherlands Institute for Health Sciences, Erasmus University, Dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands Electronic address
    Atherosclerosis 230:268-74. 2013
    ..The aim of this study is to prospectively evaluate this association in a population-based cohort...
  7. pmc Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis
    Andrew T Yan
    Division of Cardiology, St Michael s Hospital, University of Toronto, Toronto, ON, Canada
    Eur Heart J 31:875-82. 2010
    ..We sought to examine the relationship between circulating interleukin-6 (IL-6) level and regional left-ventricular (LV) function among apparently healthy individuals free of cardiovascular disease...
  8. pmc Fibrinogen and left ventricular myocardial systolic function: The Multi-Ethnic Study of Atherosclerosis (MESA)
    Raymond T Yan
    Johns Hopkins Hospital, Baltimore, MD 21287 0409, USA
    Am Heart J 160:479-86. 2010
    ..Increasing evidence suggests that elevated plasma fibrinogen is associated with incident heart failure. However, the underlying pathophysiological mechanisms have not been well elucidated...
  9. pmc Racial and ethnic differences in subclinical myocardial function: the Multi-Ethnic Study of Atherosclerosis
    Verônica Rolim S Fernandes
    Division of Cardiology, The Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287, USA
    Heart 97:405-10. 2011
    ..Racial/ethnic differences in the incidence and severity of heart failure (HF) are not well understood, but may be related to pre-existing variations in myocardial function...
  10. pmc Regional left ventricular systolic function and the right ventricle: the multi-ethnic study of atherosclerosis right ventricle study
    Christopher T Dibble
    University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    Chest 140:310-6. 2011
    ..We hypothesized that better septal function would be associated with higher RV ejection fraction and lower RV mass and volume by cardiac MRI...
  11. pmc Regional left ventricular myocardial dysfunction as a predictor of incident cardiovascular events MESA (multi-ethnic study of atherosclerosis)
    Raymond T Yan
    Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21287 0409, USA
    J Am Coll Cardiol 57:1735-44. 2011
    ..We sought to examine the prognostic value of subclinical left ventricular (LV) regional myocardial dysfunction (RMD) measured by magnetic resonance imaging (MRI) among asymptomatic individuals...
  12. pmc Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomog
    Armin Arbab-Zadeh
    Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287, USA
    J Am Coll Cardiol 59:379-87. 2012
    ..The purpose of this study was to assess the impact of patient population characteristics on accuracy by computed tomography angiography (CTA) to detect obstructive coronary artery disease (CAD)...
  13. pmc The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography
    Ilan Gottlieb
    Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    J Am Coll Cardiol 55:627-34. 2010
    ..This study was designed to evaluate whether the absence of coronary calcium could rule out >or=50% coronary stenosis or the need for revascularization...
  14. pmc Assessment of in-stent restenosis using 64-MDCT: analysis of the CORE-64 Multicenter International Trial
    Joanna J Wykrzykowska
    Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
    AJR Am J Roentgenol 194:85-92. 2010
    ..The purpose of this study was to evaluate the accuracy of 64-MDCT angiography (MDCTA) in identifying in-stent restenosis in a multicenter trial...
  15. pmc Relationship between baseline coronary calcium score and demonstration of coronary artery stenoses during follow-up MESA (Multi-Ethnic Study of Atherosclerosis)
    Boaz D Rosen
    Cardiology Division, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
    JACC Cardiovasc Imaging 2:1175-83. 2009
    ..We sought to analyze the relationship between the extent of coronary artery calcium (CAC) at baseline and the severity of coronary stenoses in clinically indicated coronary angiography studies during follow-up...
  16. pmc Age-related left ventricular remodeling and associated risk for cardiovascular outcomes: the Multi-Ethnic Study of Atherosclerosis
    Susan Cheng
    Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
    Circ Cardiovasc Imaging 2:191-8. 2009
    ..Age-related alterations of left ventricular (LV) structure and function that may predispose to cardiovascular events are not well understood...
  17. pmc Age, increased left ventricular mass, and lower regional myocardial perfusion are related to greater extent of myocardial dyssynchrony in asymptomatic individuals: the multi-ethnic study of atherosclerosis
    Boaz D Rosen
    Division of Cardiology, Department of Medicine, Blalock 524, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287 0409, USA
    Circulation 120:859-66. 2009
    ..Our goal was to study the relationships of LV mass and age with myocardial dyssynchrony among asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis...
  18. ncbi Diagnostic performance of coronary angiography by 64-row CT
    Julie M Miller
    Johns Hopkins University School of Medicine, Baltimore 21287, USA
    N Engl J Med 359:2324-36. 2008
    ..The accuracy of multidetector computed tomographic (CT) angiography involving 64 detectors has not been well established...
  19. ncbi Fast tracking of cardiac motion using 3D-HARP
    Li Pan
    Department of Biomedical Engineering, Johns Hopkins School of Medicine, 601 N Caroline St JHOC 4240, Baltimore, MD 21287, USA
    IEEE Trans Biomed Eng 52:1425-35. 2005
    ..8605 and r2 = 0.8645, respectively. The total time required for tracking 3-D cardiac motion is approximately 10 min in a 9 timeframe tagged MRI dataset and has the potential to be much faster...
  20. ncbi Coronary artery atherosclerosis is related to reduced regional left ventricular function in individuals without history of clinical cardiovascular disease: the Multiethnic Study of Atherosclerosis
    Thor Edvardsen
    Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287 0409, USA
    Arterioscler Thromb Vasc Biol 26:206-11. 2006
    ..We investigated whether regional coronary calcium score by computed tomography is related to regional left ventricular systolic function measured by MRI tagging in participants of the Multiethnic Study of Atherosclerosis...
  21. ncbi Quantitative assessment of regional myocardial function with MR-tagging in a multi-center study: interobserver and intraobserver agreement of fast strain analysis with Harmonic Phase (HARP) MRI
    Ernesto Castillo
    The Russell H Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
    J Cardiovasc Magn Reson 7:783-91. 2005
    ..To assess the reproducibility of Harmonic Phase (HARP) analysis of myocardial MR tagged images acquired in the Multi-Center Study of Atherosclerosis (MESA)...
  22. ncbi Regional diastolic dysfunction in individuals with left ventricular hypertrophy measured by tagged magnetic resonance imaging--the Multi-Ethnic Study of Atherosclerosis (MESA)
    Thor Edvardsen
    Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
    Am Heart J 151:109-14. 2006
    ..We investigated whether regional LV diastolic function measured by magnetic resonance tagging is altered in asymptomatic participants of the MESA with LVH and preserved systolic LV function...
  23. ncbi Hypertension and smoking are associated with reduced regional left ventricular function in asymptomatic: individuals the Multi-Ethnic Study of Atherosclerosis
    Boaz D Rosen
    Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
    J Am Coll Cardiol 47:1150-8. 2006
    ..This study sought to test the hypothesis that reduced regional left ventricular (LV) function is associated with traditional risk factors including hypertension, hypercholesterolemia, and smoking in asymptomatic individuals...
  24. ncbi Subclinical atherosclerosis and incipient regional myocardial dysfunction in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis (MESA)
    Veronica R S Fernandes
    Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA
    J Am Coll Cardiol 47:2420-8. 2006
    ..This study sought to determine whether increased carotid intima-media thickness (IMT) is related to reduced regional myocardial function in participants of the Multi-Ethnic Study of Atherosclerosis (MESA)...
  25. ncbi Lower myocardial perfusion reserve is associated with decreased regional left ventricular function in asymptomatic participants of the multi-ethnic study of atherosclerosis
    Boaz D Rosen
    Cardiology Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
    Circulation 114:289-97. 2006
    ..Nevertheless, the relation between flow reserve and regional myocardial function has not been studied in individuals without a history of clinical heart disease...
  26. ncbi Elevated homocysteine is associated with reduced regional left ventricular function: the Multi-Ethnic Study of Atherosclerosis
    Khurram Nasir
    Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
    Circulation 115:180-7. 2007
    ..In this study, we aim to investigate the relationship between Hcy levels and regional left ventricular function in an asymptomatic population...
  27. ncbi Relationship between C-reactive protein levels and regional left ventricular function in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis
    Boaz D Rosen
    Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
    J Am Coll Cardiol 49:594-600. 2007
    ..This study sought to investigate the relationship between C-reactive protein (CRP) and regional left ventricular (LV) function in asymptomatic individuals without a history of cardiovascular disease...
  28. ncbi Visualizing the coronaries in patients presenting with heart failure of unknown etiology
    Joao A C Lima
    J Am Coll Cardiol 49:2051-2. 2007
  29. ncbi Arterial stiffness is associated with regional ventricular systolic and diastolic dysfunction: the Multi-Ethnic Study of Atherosclerosis
    Verônica Rolim S Fernandes
    Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287, USA
    Arterioscler Thromb Vasc Biol 28:194-201. 2008
    ..Few studies have investigated the relationship between arterial compliance and LV function in humans, and none used cardiovascular MRI...
  30. ncbi The influence of left ventricular size and global function on regional myocardial contraction and relaxation in an adult population free of cardiovascular disease: a tagged CMR study of the MESA cohort
    Verônica Rolim S Fernandes
    Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287, USA
    J Cardiovasc Magn Reson 9:921-30. 2007
    ..These results are crucial to the interpretation of strain alterations induced by left ventricular remodeling in early heart failure...
  31. ncbi Novel metabolic risk factors for incident heart failure and their relationship with obesity: the MESA (Multi-Ethnic Study of Atherosclerosis) study
    Hossein Bahrami
    Cardiology Division, Department of Medicine, School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA
    J Am Coll Cardiol 51:1775-83. 2008
    ....
  32. ncbi Aortic plaque regression as determined by magnetic resonance imaging with high-dose and low-dose statin therapy
    Ilan Gottlieb
    Johns Hopkins School of Medicine, Baltimore, Maryland, USA
    J Cardiovasc Med (Hagerstown) 9:700-6. 2008
    ..We sought to compare the effects of high-dose with low-dose simvastatin therapy on aortic plaque morphology using transoesophageal magnetic resonance imaging (TEMRI)...
  33. pmc Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis
    Hossein Bahrami
    Division of Cardiology, Department of Medicine, The Johns Hopkins University, Baltimore, MD 21287, USA
    Arch Intern Med 168:2138-45. 2008
    ..Our objective was to evaluate the relationship between race/ethnicity and incident CHF...
  34. pmc Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64
    Julie M Miller
    Department of Medicine, Division of Cardiology, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA
    Eur Radiol 19:816-28. 2009
    ..In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows...
  35. ncbi The effect of intra-aortic balloon counterpulsation on left ventricular functional recovery early after acute myocardial infarction: a randomized experimental magnetic resonance imaging study
    Clerio F Azevedo
    Department of Medicine, Division of Cardiology, Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287 0409, USA
    Eur Heart J 26:1235-41. 2005
    ..We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI)...