In asymptomatic individuals, concentric left ventricular remodeling is associated with decreased regional systolic function, particularly in the LAD territory, which may reflect early transition to myocardial dysfunction.
Background— The transition from compensatory concentric remodeling to myocardial failure is not completely understood in humans. To investigate determinants of incipient myocardial dysfunction, we examined the association between concentric remodeling and regional LV function in asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Methods and Results— Myocardial tagged MRI was performed. Regional myocardial function expressed as peak systolic midwall circumferential strain (Ecc) was analyzed in 441 consecutive studies by HARP (Harmonic Phase) tool. Peak Ecc was correlated with the extent of concentric remodeling determined by the ratio of left ventricular mass to end-diastolic volume (M/V ratio). In men, a gradual decline in peak global Ecc was seen with increasing M/V ratio (test for trend, P <0.001). Among women, however, Ecc tended to be lower only in the fifth compared with the first quintile of M/V ratio ( P =0.1). The association of lower Ecc with increasing M/V ratio was regionally heterogeneous but was particularly prominent in the LAD region in men (test for trend, P <0.001) and in women (test for trend, P =0.02). In the right coronary and left circumflex artery territories, these associations were less marked in both genders. Conclusions— In this cross-sectional study of asymptomatic individuals, concentric left ventricular remodeling was related to decreased regional systolic function. The reduction in regional function, which was more pronounced in the left anterior descending coronary artery territory, may reflect the local transition from compensatory remodeling to myocardial dysfunction.
Rosen et al. (Tue,) studied this question.
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