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dc.contributor.authorPeters, M.N.
dc.contributor.authorSeliger, S.L.
dc.contributor.authorChristenson, R.H.
dc.date.accessioned2019-06-05T18:28:17Z
dc.date.available2019-06-05T18:28:17Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85042159090&doi=10.1161%2fJAHA.117.006619&partnerID=40&md5=a0ce05b788dc7d2d4fd0e2cb21e76b8d
dc.identifier.urihttp://hdl.handle.net/10713/9433
dc.description.abstractBackground: As heart failure (HF)‐associated morbidity and mortality continue to escalate, enhanced focus on prevention is increasingly important. “Malignant” left ventricular (LV) hypertrophy (LVH): LVH combined with an elevated cardiac biomarker reflecting either injury (high‐sensitivity cardiac troponin T), or strain (amino‐terminal pro‐B‐type natriuretic peptide) has predicted accelerated progression to HF. We sought to determine whether malignant LVH identified community‐dwelling adults initially free of cardiovascular disease at high risk of asymptomatic decline in LV ejection fraction or a clinical cardiovascular event. Methods and Results: A total of 4985 of 6814 individuals without prevalent cardiovascular disease underwent baseline cardiac magnetic resonance for LVH in combination with measurement of plasma high‐sensitivity cardiac troponin T and amino‐terminal pro‐B‐type natriuretic peptide as part of MESA (Multi‐Ethnic Study of Atherosclerosis) and were subsequently divided into 4 groups: (1) No LVH, no elevated biomarkers (n=2206; 44.3%); (2) No LVH, ≥1 elevated biomarkers (n=2275; 45.7%); (3) LVH, no elevated biomarkers (n=153; 3.0%); and (4) LVH, ≥1 elevated biomarkers (malignant LVH; n=351; 7.0%). Cardiac magnetic resonance was repeated 10 years later (n=2831) for assessment of LV ejection fraction <50%. Median follow‐up was 12.2 years. Malignant LVH was associated with 7.0‐, 3.5‐, and 2.6‐fold adjusted increases in incidence of HF, cardiovascular death, and asymptomatic LV dysfunction, respectively, versus group 1. New‐onset HF was predominately HF with reduced ejection fraction (9.5‐fold increase). Conclusions: Malignant LVH is predictive of progression to asymptomatic LV dysfunction, HF (particularly HF with reduced ejection fraction), and cardiovascular death. Consequently, malignant LVH represents a high‐risk phenotype among individuals without known cardiovascular disease, which should be targeted for increased surveillance and more‐aggressive therapies. Copyright 2018 The Authors.en_US
dc.description.sponsorshipThis research was supported by contracts HHSN 268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from NCRR. Roche Diagnostics supported the measurement of hs-cTnT and additional NT-proBNP through an investigator-initiated grant (PI: deFilippi).en_US
dc.description.urihttps://dx.doi.org/10.1161/JAHA.117.006619en_US
dc.language.isoen-USen_US
dc.publisherAmerican Heart Association Inc.en_US
dc.relation.ispartofJournal of the American Heart Association
dc.subjectHeart failureen_US
dc.subjectLeft ventricular dysfunctionen_US
dc.subjectLeft ventricular hypertrophyen_US
dc.subjectMortalityen_US
dc.subjectN-terminal pro-B-typeen_US
dc.subjectTroponin Ten_US
dc.title"Malignant" left ventricular hypertrophy identifies subjects at high risk for progression to asymptomatic left ventricular dysfunction, heart failure, and death: MESA (Multi-Ethnic Study of Atherosclerosis)en_US
dc.typeArticleen_US
dc.identifier.doi10.1161/JAHA.117.006619


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