High-sensitivity C-reactive protein as an independent predictor of progressive myocardial functional deterioration: The multiethnic study of atherosclerosis
American Heart Journal, 07/11/2012
Choi EY et al. – Higher C–reactive protein (CRP) levels are related to progressive myocardial functional deterioration independent of subclinical atherosclerosis and clinical coronary events in asymptomatic individuals without previous history of heart disease.Methods
- Regional myocardial functional data from MESA participants who had baseline CRP measurement and also underwent tagged cardiac magnetic resonance imaging both at baseline and at 5–year follow–up were analyzed.
- Left ventricular midwall and midslice peak circumferential strain (Ecc), of which a more negative value denotes stronger regional myocardial function, was measured.
- Circumferential strain change was calculated as the difference between baseline and follow–up Ecc.
- During the follow–up period, participants (n = 785) with elevated CRP experienced a decrease in strain, independent of age, gender, and ethnicity (B = 0.081, ΔEcc change per 1 mg/L CRP change, 95% CI 0.036–0.126, P < .001, model 1) and, additionally, beyond systolic blood pressure, heart rate, diabetes, smoking status, body mass index, current medication, and glomerular filtration rate (B = 0.099, 0.052–0.145, P < .001, model 2).
- The relationship remained statistically significant after further adjustment for left ventricular mass, coronary calcium score, and interim clinical coronary events (B = 0.098, 0.049–0.147, P < .001, model 3).