Low left ventricular sphericity volume index predicted incident cardiovascular disease (HR 1.82; 95% CI 1.47-2.27), while extreme sphericity strongly predicted incident heart failure.
Cohort (n=5,004)
Does left ventricular sphericity volume index predict incident cardiovascular events in a multiethnic population free of known CVD?
Left ventricular sphericity volume index measured by MRI provides differential predictive value for incident cardiovascular events, improving risk prediction models specifically for heart failure.
Effect estimate: HR 1.82 (95% CI 1.47-2.27)
OBJECTIVE: To investigate whether sphericity volume index (SVI), an indicator of left ventricular (LV) remodelling, predicts incident cardiovascular events (coronary heart disease, CHD; all cardiovascular disease, CVD; heart failure, HF; atrial fibrillation, AF) over 10 years of follow-up in a multiethnic population (Multi-Ethnic Study of Atherosclerosis). METHODS: 5004 participants free of known CVD had magnetic resonance imaging (MRI) in 2000-2002. Cine images were analysed to compute, Formula: see text equivalent to LV volume/volume of sphere with length of LV as the diameter. The highest (greatest sphericity) and lowest (lowest sphericity) quintiles of SVI were compared against the reference group (2-4 quintiles combined). Risk-factor adjusted hazard's ratio (HR) from Cox regression assessed the predictive performance of SVI at end-diastole (ED) and end-systole (ES) to predict incident outcomes over 10 years in retrospective interpretation of prospective data. RESULTS: At baseline, participants were aged 61±10 years; 52% men and 39%/13%/26%/22% Cauc/Chinese/Afr-Amer/Hispanic. Low sphericity was associated with higher Framingham CVD risk, greater coronary calcium score and higher N-terminal pro-brain natriuretic peptide (NT-proBNP); while increased sphericity was associated with higher NT-proBNP and lower ejection fraction. Low sphericity predicted incident CHD (HR: 1.48, 1.55-2.59 at ED) and CVD (HR: 1.82, 1.47-2.27 at ED). However, both low (HR: 1.81, 1.20-2.73 at ES) and high (HR: 2.21, 1.41-3.46 at ES) sphericity predicted incident HF. High sphericity also predicted AF. CONCLUSIONS: In a multiethnic population free of CVD at baseline, lowest sphericity was a predictor of incident CHD, CVD and HF over a 10-year follow-up period. Extreme sphericity was a strong predictor of incident HF and AF. SVI improved risk prediction models beyond established risk factors only for HF, but not for all CVD or CHD.
Ambale‐Venkatesh et al. (Fri,) conducted a cohort in Free of known cardiovascular disease (n=5,004). Sphericity volume index (SVI) vs. Reference group (2-4 quintiles combined) was evaluated on Incident cardiovascular events (coronary heart disease, all cardiovascular disease, heart failure, atrial fibrillation) (HR 1.82, 95% CI 1.47-2.27). Low left ventricular sphericity volume index predicted incident cardiovascular disease (HR 1.82; 95% CI 1.47-2.27), while extreme sphericity strongly predicted incident heart failure.