Supranormal Left Ventricular Ejection Fraction, Stroke Volume, and Cardiovascular Risk: Findings From...

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Preventive Cardiology

Background:

• Supranormal ejection fraction (EF) detected by echocardiography is linked to increased cardiovascular disease (CVD) risk in patients.
• The prognostic significance of supranormal left ventricular ejection fraction (LVEF) assessed by cardiac magnetic resonance (CMR) in healthy individuals is not well understood.

Purpose of the Study:

• To examine the prognostic implication of supranormal LVEF measured by CMR.
• To investigate the relationship between supranormal LVEF and stroke volume in community-dwelling adults without CVD.

Main Methods:

• Analysis of participants from the MESA and DHS cohorts without pre-existing CVD.
• Assessment of major adverse cardiovascular events (MACE) risk using adjusted Cox models based on LVEF categories.
• Subgroup analysis of LVEF and MACE risk stratified by left ventricular stroke volume index.

Main Results:

• Higher LVEF (Q4 vs Q1) was associated with increased MACE risk in both MESA and DHS cohorts (MESA HR=1.27, DHS HR=1.72).
• A significant interaction between LVEF and stroke volume index indicated that higher LVEF increased MACE risk primarily in individuals with low stroke volume (P interaction=0.02).

Conclusions:

• Supranormal LVEF in community-dwelling adults without CVD is associated with a higher risk of adverse cardiovascular outcomes.
• The elevated risk is particularly pronounced in individuals with lower stroke volume, underscoring the clinical relevance of this finding.