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Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Racial and ethnic differences in subclinical myocardial function: the Multi-Ethnic Study of Atherosclerosis
Verônica Rolim S Fernandes1, Susan Cheng, Yu-Jen Cheng
1Division of Cardiology, The Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287, USA.
Insights
Racial and ethnic differences exist in heart muscle function among healthy individuals. Chinese-Americans showed stronger systolic contraction, while African-Americans and Hispanics had weaker function, highlighting disparities in cardiovascular health.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Racial Health Disparities
Background:
- Heart failure (HF) incidence and severity vary across racial/ethnic groups, potentially due to underlying differences in myocardial function.
- Understanding these variations is crucial for addressing health disparities in cardiovascular disease.
Purpose of the Study:
- To investigate racial/ethnic differences in regional left ventricular (LV) myocardial function.
- To assess these differences in asymptomatic individuals without known cardiovascular disease.
Main Methods:
- Utilized data from the Multi-Ethnic Study of Atherosclerosis, a prospective observational study.
- Employed cardiac MRI with tissue tagging on 1099 participants from four major racial/ethnic groups.
- Analyzed peak systolic strain (Ecc) and strain rate (SRs) in four LV regions using multiple linear regression, adjusting for cardiovascular risk factors.
Main Results:
- Chinese-Americans exhibited the greatest magnitude of LV systolic strain (Ecc) and strain rate (SRs) across most regions.
- African-Americans showed the lowest Ecc values in the majority of LV regions.
- Hispanics demonstrated the lowest SRs, indicating reduced contractility, compared to other groups.
- These race-based differences persisted after adjusting for factors like hypertension and LV mass.
Conclusions:
- Significant race-based variations in regional LV systolic function were observed in a large cohort of asymptomatic individuals.
- These findings underscore the importance of considering race/ethnicity in understanding cardiovascular health.
- Further research is warranted to elucidate the mechanisms underlying these observed disparities in myocardial function.
Background:
Racial/ethnic differences in the incidence and severity of heart failure (HF) are not well understood, but may be related to pre-existing variations in myocardial function.
Objective:
To examine racial/ethnic differences in regional myocardial function among asymptomatic individuals free of known cardiovascular disease.
Design, Setting And Patients:
The Multi-Ethnic Study of Atherosclerosis is a prospective, observational study of individuals without baseline cardiovascular disease, representing four major racial/ethnic groups. A total of 1099 study participants underwent cardiac MRI with tissue tagging; for each study, peak systolic strain (Ecc) and strain rate (SRs) were determined in four left ventricular (LV) regions.
Main Outcome Measures:
Multiple linear regression was used to analyse the relationship between race/ethnicity and regional strain (Ecc and SRs) while adjusting for cardiovascular risk factors.
Results:
Compared with other racial/ethnic groups, Chinese-Americans had the greatest magnitude of Ecc in a majority of LV regions (-19.60±3.78, p<0.05); Chinese-Americans also had the greatest absolute values for SRs in all regions, reflecting higher rate of systolic contraction (-2.01±0.76, p<0.05). Conversely, African-Americans had the lowest Ecc values (-17.50±4.00, p<0.05) in the majority of wall regions while Hispanics demonstrated the lowest rate of contractility in all wall regions (-1.44±0.50, p≤0.001) in comparison with the other racial/ethnic groups. These race-based differences remained significant in the majority of LV wall regions after adjusting for multiple variables, including hypertension and LV mass.
Conclusions:
Important race-based differences in regional LV systolic function in a large cohort of asymptomatic individuals have been demonstrated. Further research is needed to investigate the possible mechanisms related to the race/ethnicity-based variations found in this study.
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