John Jeffrey Carr
Professor of Radiology, Biomedical Informatics and Cardiovascular Medicine
Last active: 1/10/2020

Usefulness of biventricular volume as a predictor of mortality in patients with diabetes mellitus (from the Diabetes Heart Study).

Cox AJ, Hugenschmidt CE, Wang PT, Hsu FC, Kenchaiah S, Daniel K, Langefeld CD, Freedman BI, Herrington DM, Carr JJ, Stacey B, Bowden DW
Am J Cardiol. 2013 111 (8): 1152-8

PMID: 23351459 · PMCID: PMC3618594 · DOI:10.1016/j.amjcard.2012.12.044

Patients with type 2 diabetes mellitus are at increased risk for cardiovascular disease (CVD) and mortality. Beyond traditional CVD risk factors, novel measures reflecting additional aspects of disease pathophysiology, such as biventricular volume (BiVV), may be useful for risk stratification. The aim of this study was to examine the relationship between BiVV and risk for mortality in European Americans with type 2 diabetes mellitus from the Diabetes Heart Study (DHS). BiVV was calculated from 771 noncontrast computed tomographic scans performed to image coronary artery calcified plaque. Relationships between BiVV and traditional CVD risk factors were examined. Cox proportional-hazards regression was performed to determine risk for mortality (all-cause and CVD mortality) associated with increasing BiVV. Area under the curve analysis was used to assess BiVV utility in risk prediction models. During 8.4 ± 2.4 years of follow-up, 23% of the patients died. In unadjusted analyses, BiVV was significantly associated with increasing body mass index, height, coronary artery calcified plaque, history of hypertension, and previous myocardial infarction (p <0.0001 to 0.012). BiVV was significantly associated with all-cause (hazard ratio 2.45, 95% confidence interval 1.06 to 5.67, p = 0.036) and CVD (hazard ratio 4.36, 95% confidence interval 1.36 to 14.03, p = 0.014) mortality in models adjusted for other known CVD risk factors. Area under the curve increased from 0.76 to 0.78 (p = 0.04) and from 0.74 to 0.77 (p = 0.02) for all-cause and CVD mortality with the inclusion of BiVV. In conclusion, in the absence of echocardiography or other noninvasive imaging modalities to assess ventricular volumes, or when such methods are contraindicated, BiVV from computed tomography may be considered a tool for the stratification of high-risk patients, such as those with type 2 diabetes mellitus.

Copyright © 2013 Elsevier Inc. All rights reserved.

MeSH Terms (19)

Adult Aged Aged, 80 and over Cardiac-Gated Imaging Techniques Carotid Intima-Media Thickness Diabetes Mellitus, Type 2 Electrocardiography Female Heart Ventricles Humans Magnetic Resonance Imaging Male Middle Aged Predictive Value of Tests Proportional Hazards Models Risk Factors ROC Curve Stroke Volume Tomography, Spiral Computed

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