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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:206.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Coronary Artery Atherosclerosis Is Related to Reduced Regional Left Ventricular Function in Individuals Without History of Clinical Cardiovascular Disease

The Multiethnic Study of Atherosclerosis

Thor Edvardsen; Robert Detrano; Boaz D. Rosen; J. Jeffrey Carr; Kiang Liu; Shenghan Lai; Steven Shea; Li Pan; David A. Bluemke; João A.C. Lima

From the Division of Cardiology (T.E., B.D.R., L.P., J.A.C.L.), Department of Epidemiology (S.L.), and Department of Radiology (D.A.B.,J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology (R.D.), University of California Los Angeles School of Medicine, Torrance, CA; Department of Radiology (J.J.C.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Preventive Medicine (K.L.), Feinberg School of Medicine, Northwestern University, Chicago, IL; and Department of Medicine and Epidemiology (S.S.), Schools of Medicine and Public Health, Columbia University, New York, NY.

Correspondence to Joao A.C. Lima, Johns Hopkins Hospital, Cardiology Division, 600 N Wolfe St/Blalock 524, Baltimore, MD 21287-0409. E-mail jlima{at}jhmi.edu

Objective— We investigated whether regional coronary calcium score by computed tomography is related to regional left ventricular systolic function measured by MRI tagging in participants of the Multiethnic Study of Atherosclerosis.

Methods and Results— The Multiethnic Study of Atherosclerosis is a prospective observational study of men and women without a history of previous heart disease from 4 ethnic groups. Calcium scores were measured separately for the left anterior descendent (LAD), left circumflex (LCX), and right (RCA) coronary arteries. Left ventricular strain and strain rate were determined by tagged MRI in the corresponding vascular territories of the coronary vessels in 509 participants. Greater coronary calcification in the LAD, LCX, and right RCA coronary arteries were related to worse function in their respective perfusion. Anterior wall strain rate was –1.37±0.41 when LAD calcium was zero versus –1.17±0.24 1/s in the highest quartile of calcium score (P<0.001). Similar relationships were evident in the LCX and RCA regions. Participants with 1- and 2-vessel coronary artery calcium had better myocardial function in the remote area compared with the territory supplied by the diseased artery.

Conclusions— High-local calcium score is related to regional dysfunction in the corresponding coronary territory among individuals without a history of previous heart disease. These results indicate a link between atherosclerosis and subclinical regional left ventricular dysfunction.

Participants of the Multiethnic Study of Atherosclerosis without history of previous heart disease were studied by MRI tagging and computed tomography. Greater coronary calcification in all coronary arteries were related to worse function in their respective perfusion territories. These results indicate a link between atherosclerosis and subclinical regional left ventricular dysfunction.

Key Words: atherosclerosis • coronary circulation • calcification • MRI • myocardial function

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