ArticleRadiology2024
Differential Stroke Volume between Left and Right Ventricles as a Predictor of Clinical Outcomes: The MESA Study.
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13 authors.
Ashkan AbdollahiFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0003-3009-9307
Yoko KatoFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0002-4328-1987
Hooman BakhshiFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Vinithra VaradarajanFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Omar ChehabFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Ralph ZeitounFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Mohammad R OstovanehFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Colin O WuFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0002-4514-0926
Alain G BertoniFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Sanjiv J ShahFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).
Bharath Ambale-VenkateshFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0002-2330-2373
David A BluemkeFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0002-8323-8086
João A C LimaFrom the Division of Cardiology, Department of Medicine (A.A., Y.K., H.B., V.V., O.C., R.Z., M.R.O., J.A.C.L.), and Department of Radiology (B.A.V.), Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287-0409; Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (C.O.W.); Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.); Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (S.J.S.); and Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (D.A.B.).ORCID 0000-0001-8756-6995
Funding
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1MClinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2MCigarette Smoke and Susceptibility to Influenza InfectionR01HL095163 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JASPERS, ILONA, NOAH, TERRY L · 2009 to 2013
$2.0MAdjunctive Use of Apyrase to Fibrinolytic TherapyR44HL095169 · NHLBI · APT THERAPEUTICS, INC. · PI CHEN, RIDONG · 2012 to 2013
$1.3MSUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001
$758kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001
$642kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001
$616kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095160 · HC · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SAAD, MOHAMMED F · 1999 to 2001
$592kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095164 · HC · NORTHWESTERN UNIVERSITY · PI LIU, KIANG JOHN · 1999 to 2001
$511kSUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095163 · HC · UNIVERSITY OF MINNESOTA TWIN CITIES · PI FOLSOM, AARON R · 1999 to 2001
$443kEnhancing immune reconstitution after implantation of postnatal allogeneic thymusR21HL095165 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CROOKS, GAY M · 2008 to 2009
$440kNCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR001079NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169
Abstract
Background Valvular heart disease and intracardiac shunts can disrupt the balance between left ventricular (LV) and right ventricular (RV) stroke volumes. However, the prognostic value of such imbalances has not been established among asymptomatic individuals. Purpose To assess the association between differential ventricular stroke volumes quantified using cardiac MRI and clinical outcomes in individuals without cardiovascular disease. Materials and Methods This secondary analysis of a prospective study included participants without cardiovascular disease at enrollment (July 2000 to July 2002) who underwent cardiac MRI. Differences in stroke volume were calculated as LV stroke volume minus RV stroke volume, and participants were categorized as having balanced (greater than or equal to -30 mL to ≤30 mL), negative (less than -30 mL), or positive (>30 mL) differential stroke volumes. Multivariable Cox proportional hazard regression models were used to test the association between differences in stroke volume and adverse outcomes. Results A cohort of 4058 participants (mean age, 61.4 years ± 10 [SD]; 2120 female) were included and followed up for a median of 18.4 years (IQR, 18.3-18.5 years). During follow-up, 1006 participants died, 235 participants developed heart failure, and 764 participants developed atrial fibrillation. Compared with participants who had a balanced differential stroke volume, those with an increased differential stroke volume showed a higher risk of mortality (hazard ratio [HR], 1.73 [95% CI: 1.12, 2.67];
Indexed as
Heart VentriclesMagnetic Resonance ImagingStroke VolumeAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisProspective Studies
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