Comparing incidence of heart failure in individuals with enlarged cardiac chambers versus diabetes.
Opportunistic cardiac chamber volumetry derived from coronary artery calcium (CAC) scans using the AI-CVD platform predicts heart failure (HF) independent of conventional risk factors. Type 2 diabetes mellitus (T2DM), which classifies individuals as Stage A HF, is associated with chamber enlargement; however, the HF risk associated with chamber enlargement in the absence of T2DM has not been characterized.
We analyzed left atrial (LA) and left ventricular (LV) volumes and mass, indexed to body surface area, using AI-CVD chamber volumetry of 7585 asymptomatic participants in the pooled cohort of Multi-Ethnic Study of Atherosclerosis (MESA) and Framingham Heart Study (FHS) second, and third generation (MESA & FHS; mean age 62.7 ± 14.6 years, 48.6 % male, 10.6 % with T2DM). Chambers were classified as enlarged (≥95th) or normal (<50th percentile). Cox regression and Kaplan-Meier analyses with log-rank tests were performed.
Over a median follow-up of 17.1 years, 438 HF events occurred. Individuals without T2DM, with enlarged chambers had HF incidence rates comparable to or higher than individuals with T2DM and normal chambers: LA volume 16.4 vs 8.7 (p = 0.001), LV volume 8.1 vs 8.9 (p = 0.66), and LV mass 10.1 vs 8.9 (p = 0.55) per 1000 person-years. After multivariable adjustment, compared with normal chambers, enlarged LA (HR 2.5[1.9-3.3]), LV (HR 3.5[2.3-5.4]), and LV mass (HR 3.2[2.2-4.9]) remained independently associated with HF in individuals without T2DM.
AI-derived cardiac chamber enlargement measured in CAC scans is associated with HF incidence in individuals without T2DM, supporting its potential utility in HF risk stratification.
We analyzed left atrial (LA) and left ventricular (LV) volumes and mass, indexed to body surface area, using AI-CVD chamber volumetry of 7585 asymptomatic participants in the pooled cohort of Multi-Ethnic Study of Atherosclerosis (MESA) and Framingham Heart Study (FHS) second, and third generation (MESA & FHS; mean age 62.7 ± 14.6 years, 48.6 % male, 10.6 % with T2DM). Chambers were classified as enlarged (≥95th) or normal (<50th percentile). Cox regression and Kaplan-Meier analyses with log-rank tests were performed.
Over a median follow-up of 17.1 years, 438 HF events occurred. Individuals without T2DM, with enlarged chambers had HF incidence rates comparable to or higher than individuals with T2DM and normal chambers: LA volume 16.4 vs 8.7 (p = 0.001), LV volume 8.1 vs 8.9 (p = 0.66), and LV mass 10.1 vs 8.9 (p = 0.55) per 1000 person-years. After multivariable adjustment, compared with normal chambers, enlarged LA (HR 2.5[1.9-3.3]), LV (HR 3.5[2.3-5.4]), and LV mass (HR 3.2[2.2-4.9]) remained independently associated with HF in individuals without T2DM.
AI-derived cardiac chamber enlargement measured in CAC scans is associated with HF incidence in individuals without T2DM, supporting its potential utility in HF risk stratification.
Authors
Mirjalili Mirjalili, Atlas Atlas, Reeves Reeves, Zhang Zhang, Wasserthal Wasserthal, Azimi Azimi, Hashemi Hashemi, Mozafarybazargany Mozafarybazargany, Ghaffari Jolfayi Ghaffari Jolfayi, Atlas Atlas, Henschke Henschke, Yankelevitz Yankelevitz, Zulueta Zulueta, Mechanick Mechanick, Branch Branch, Ma Ma, Yip Yip, Fan Fan, Roy Roy, Nasir Nasir, Molloi Molloi, Fayad Fayad, McConnell McConnell, Kakadiaris Kakadiaris, Abela Abela, Vliegenthart Vliegenthart, Maron Maron, Narula Narula, Williams Williams, Shah Shah, Budoff Budoff, Levy Levy, Mehran Mehran, Kloner Kloner, Wong Wong, Naghavi Naghavi
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