scholarly journals 10-Year Follow-up of Subclinical Cardiovascular Disease and Risk of Coronary Heart Disease in the Cardiovascular Health Study

2006 ◽  
Vol 166 (1) ◽  
pp. 71 ◽  
Author(s):  
Lewis H. Kuller
Heart ◽  
2021 ◽  
pp. heartjnl-2021-319296
Author(s):  
Daniele Massera ◽  
Mo Hu ◽  
Joseph A Delaney ◽  
Traci M Bartz ◽  
Megan E Bach ◽  
...  

ObjectivesSpeckle-tracking echocardiography enables detection of abnormalities in cardiac mechanics with higher sensitivity than conventional measures of left ventricular (LV) dysfunction and may provide insight into the pathogenesis of coronary heart disease (CHD). We investigated the relationship of LV longitudinal strain, LV early diastolic strain rate (SR) and left atrial (LA) reservoir strain with long-term CHD incidence in community-dwelling older adults.MethodsThe association of all three strain measures with incidence of non-fatal and fatal CHD (primary outcome of revascularisation, non-fatal and fatal myocardial infarction) was examined in the population-based Cardiovascular Health Study using multivariable Cox proportional hazards models. Follow-up was truncated at 10 years.ResultsWe included 3313 participants (mean (SD) age 72.6 (5.5) years). During a median follow-up of 10.0 (25th–75th percentile 7.7–10.0) years, 439 CHD events occurred. LV longitudinal strain (HR=1.25 per SD decrement, 95% CI 1.09 to 1.43) and LV early diastolic SR (HR=1.31 per SD decrement, 95% CI 1.14 to 1.50) were associated with a significantly greater risk of incident CHD after adjustment for potential confounders. By contrast, LA reservoir strain was not associated with incident CHD (HR=1.06 per SD decrement, 95% CI 0.94 to 1.19). Additional adjustment for biochemical and echocardiographic measures of myocardial stress, dysfunction and remodelling did not meaningfully alter these associations.ConclusionWe found an association between echocardiographic measures of subclinically altered LV mechanics and incident CHD. These findings inform the underlying biology of subclinical LV dysfunction and CHD. Early detection of asymptomatic myocardial dysfunction may offer an opportunity for prevention and early intervention.


2007 ◽  
Vol 53 (3) ◽  
pp. 539-540 ◽  
Author(s):  
Michael M Hoffmann ◽  
Peter Bugert ◽  
Ursula Seelhorst ◽  
Britta Wellnitz ◽  
Bernhard R Winkelmann ◽  
...  

2017 ◽  
Vol 31 (4) ◽  
pp. 652-666
Author(s):  
Nicole M. Armstrong ◽  
Michelle C. Carlson ◽  
Qian-Li Xue ◽  
Jennifer Schrack ◽  
Mercedes R. Carnethon ◽  
...  

Objectives: To evaluate whether late-life depression mediates the association of subclinical cardiovascular disease (CVD) with all-cause mortality. Method: Using data from 3,473 Cardiovascular Health Study participants, the Cox proportional hazards model was used to examine the direct and indirect (via late-life depression) effects of the association between baseline subclinical CVD and all-cause mortality with weights derived from multivariable logistic regression of late-life depression on subclinical CVD. Results: Subclinical CVD led to a higher risk of all-cause mortality (hazard ratio [HR] = 1.51, 95% confidence interval, [CI] = [1.42, 1.94]). Total effect of subclinical CVD on all-cause mortality was decomposed into direct (HR = 1.41, 95% CI = [1.37, 1.58]) and indirect (HR = 1.07, 95% CI = [1.01, 1.23]) effects; 16.3% of the total effect of subclinical CVD on all-cause mortality was mediated by late-life depression. Discussion: Late-life depression accounts for little, if any, of the association between subclinical CVD, a risk factor of all-cause mortality, and all-cause mortality.


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