Electrocardiographic Strain Pattern Is Associated With Left Ventricular Concentric Remodeling, Scar, and Mortality Over 10 Years: The Multi‐Ethnic Study of Atherosclerosis

• Published in: Journal of the American Heart Association 2017-09, Vol.6 (9), p.n/a
• Main Authors: Inoue, Yuko Y., Soliman, Elsayed Z., Yoneyama, Kihei, Ambale‐Venkatesh, Bharath, Wu, Colin O., Sparapani, Rodney, Bluemke, David A., Lima, João A.C., Ashikaga, Hiroshi
• Format: Article
• Language: English
• Subjects: cardiovascular magnetic resonance imaging; cardiovascular outcomes; ECG; Original Research; remodeling; repolarization
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.117.006624

Background Both ECG strain pattern and QRS measured left ventricular (LV) hypertrophy criteria are associated with LV hypertrophy and have been used for risk stratification. However, the independent predictive value of ECG strain in apparently healthy individuals in predicting mortality and adverse cardiovascular events is unclear. Methods and Results MESA (Multi‐Ethnic Study of Atherosclerosis) is a multicenter, prospective cohort of 6441 participants (mean age, 62 years; 54% women). In 2847 of these participants, cardiac magnetic resonance imaging was repeated ≈10 years later (Year‐10). At Year‐10, 1759 participants underwent cardiac magnetic resonance imaging with gadolinium to detect myocardial scar. During a median follow‐up of 11.7 years, ECG strain (n=168, 2.6%) was significantly associated with all‐cause death (adjusted hazard ratio, 1.33; 95% confidence interval, 1.01–1.77; P=0.045), heart failure (2.62; 1.73–3.97; P