Association of Subclinical Cardiac Remodeling With Incident Cancer in the MESA Cohort

Figures

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  Figure 1. Incidence rates with 95% CIs of all cancers and cancer subtypes stratified by cardiac MRI measures. Incidence rates for LV remodeling (LV mass index and LV mass/volume ratio) in quartiles and LA remodeling (LAEF, LAVI, and LA strain) in tertiles (A); and LVEF (≥50% vs <50%) and the presence of LV hypertrophy (B). Incidence rates were calculated as per 10 000 person‐years. LA indicates left atrial; LAEF, LA emptying fraction; LAVI, LA maximum volume indexed to body surface area; LV, left ventricular; LVEF, LV ejection fraction; and MRI, magnetic resonance imaging.

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  Figure 2. HRs with 95% CIs for cardiac MRI measures for cancer end points in adjusted models. HRs for cardiac MRI measures for each cancer end point were calculated from per 1‐SD increment in models 1 and 2. Variables for model 1: age, sex, race and ethnicity, education level, and health insurance status (private and public). Model 2: all variables from model 1 plus smoking status, pack‐years of cigarette smoking, diabetes, body mass index, antihypertensive medication use, systolic blood pressure, total and high‐density lipoprotein cholesterol levels, statin use, estimated glomerular filtration rate, diet, and physical activity. For breast cancer and female‐specific cancer end points, additional female‐specific adjustments were made for menopausal stage, hormone replacement therapy, age at menarche, and age at first birth (21≤age <25 years; age ≥25 years; and no children). HR indicates hazard ratio; LA, left atrial; LAEF, LA emptying fraction; LAVI, LA maximum volume indexed to body surface area; LV, left ventricular; LVEF, LV ejection fraction; and MRI, magnetic resonance imaging.

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  Figure 3. Variable importance analysis for all primary predictors in the same model. Variables included in models 1 and 2 are listed in the Figure 2 legend. LA indicates left atrial; LAEF, LA emptying fraction; LAVI, LA maximum volume indexed to body surface area; LV, left ventricular; and LVEF, LV ejection fraction.

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  Figure 4. Association of LV and LA structural and functional remodeling with increased cancer risk in the MESA cohort. In the MESA cohort over a median follow‐up period of 18.7 years, the incidence of all cancers per 10 000 person‐years generally increased with subclinical cardiac remodeling. Elevated LV mass index and reduced peak LA strain were associated with an increased risk of incident breast and colorectal cancer, respectively. This figure was generated using Servier Medical Art, provided by Servier, licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). CVD indicates cardiovascular disease; Exam, examination; HR, hazard ratio; LA, left atrial; LV, left ventricular; MESA, Multi‐Ethnic Study of Atherosclerosis; and MRI, magnetic resonance imaging.