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Association of left ventricular ejection fraction with risk of cardiovascular diseases: a prospective cohort study

Jun Xiao1,2, Han Wu3, Ziting Gao4

  • 1Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou City, 350001, Fujian Province, China. xiaojun@fjmu.edu.cn.

Scientific Reports
|October 25, 2024
PubMed

Insights

Subtle changes in left ventricular ejection fraction (LVEF) show a U-shaped risk for cardiovascular diseases. Both low and high LVEF levels increase risks, with specific associations varying by disease and patient factors.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Public Health

Background:

  • Left ventricular ejection fraction (LVEF) is a key metric in cardiac assessments.
  • Understanding the full spectrum of LVEF's association with cardiovascular disease (CVD) risk is crucial.

Purpose of the Study:

  • To investigate the relationship between subtle variations in LVEF and the risk of developing common cardiovascular diseases.
  • To identify specific CVDs associated with different LVEF ranges.

Main Methods:

  • Prospective cohort study utilizing UK Biobank data.
  • Left ventricular ejection fraction (LVEF) assessed via cardiac magnetic resonance imaging.
  • Cox proportional hazard models used to analyze incident cardiovascular events (heart failure, atrial fibrillation, ischemic heart disease, myocardial infarction).

Main Results:

  • A U-shaped relationship was found between LVEF and overall cardiovascular event risk, with the lowest risk observed at LVEF 55-64%.
  • Both low LVEF (40-54%) and high LVEF (≥65%) were associated with increased CVD risk compared to moderate LVEF.
  • Low LVEF increased heart failure risk; high LVEF increased ischemic heart disease risk. Both were borderline associated with atrial fibrillation.

Conclusions:

  • The study confirms a U-shaped association between LVEF and cardiovascular disease risk.
  • These associations are disease-specific and influenced by patient demographics (age, sex) and comorbidities.
  • Subtle deviations from the optimal LVEF range (55-64%) signify increased cardiovascular risk.

Keywords:
Cardiovascular diseasesCohortEpidemiologyLeft ventricular ejection fraction

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