John Jeffrey Carr
Professor of Radiology, Biomedical Informatics and Cardiovascular Medicine
Last active: 9/11/2017

High-sensitivity C-reactive protein as an independent predictor of progressive myocardial functional deterioration: the multiethnic study of atherosclerosis.

Choi EY, Yan RT, Fernandes VR, Opdahl A, Gomes AS, Almeida AL, Wu CO, Liu K, Carr JJ, McClelland RL, Bluemke DA, Lima JA
Am Heart J. 2012 164 (2): 251-8

PMID: 22877812 · PMCID: PMC3417227 · DOI:10.1016/j.ahj.2012.05.010

BACKGROUND - Systemic inflammation has been linked to the development of heart failure in population studies including Multi-Ethnic Study of Atherosclerosis (MESA), but little evidence exists regarding potential mechanism of this relationship. In this study, we used longitudinal magnetic resonance imaging follow-up analysis to examine whether C-reactive protein (CRP) levels relate to progressive myocardial functional deterioration as a potential mechanism of incident heart failure.

METHODS - Regional myocardial functional data from MESA participants who had baseline CRP measurement and also underwent tagged cardiac magnetic resonance imaging both at baseline and at 5-year follow-up were analyzed. Left ventricular midwall and midslice peak circumferential strain (Ecc), of which a more negative value denotes stronger regional myocardial function, was measured. Circumferential strain change was calculated as the difference between baseline and follow-up Ecc.

RESULTS - During the follow-up period, participants (n = 785) with elevated CRP experienced a decrease in strain, independent of age, gender, and ethnicity (B = 0.081, ∆Ecc change per 1 mg/L CRP change, 95% CI 0.036-0.126, P < .001, model 1) and, additionally, beyond systolic blood pressure, heart rate, diabetes, smoking status, body mass index, current medication, and glomerular filtration rate (B = 0.099, 0.052-0.145, P < .001, model 2). The relationship remained statistically significant after further adjustment for left ventricular mass, coronary calcium score, and interim clinical coronary events (B = 0.098, 0.049-0.147, P < .001, model 3).

CONCLUSION - Higher CRP levels are related to progressive myocardial functional deterioration independent of subclinical atherosclerosis and clinical coronary events in asymptomatic individuals without previous history of heart disease.

Copyright © 2012 Mosby, Inc. All rights reserved.

MeSH Terms (16)

Aged Aged, 80 and over Atherosclerosis Biomarkers C-Reactive Protein Disease Progression Female Heart Heart Failure Humans Magnetic Resonance Imaging Male Middle Aged Myocardium Predictive Value of Tests Prospective Studies

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