Electrocardiographic Associations of Cardiac Biomarkers and Cardiac Magnetic Resonance Measures of Fibrosis in the Multiethnic Study of Atherosclerosis (MESA)
Copyright © 2023 Elsevier Inc. All rights reserved..
Abnormalities in myocardial substrate, including diffuse and replacement fibrosis, increase the risk of cardiovascular disease (CVD). Data are sparse on whether electrocardiogram (ECG) measures, coupled with circulating biomarkers, may aid in identifying cardiac fibrosis. This study aimed to determine whether 12-lead ECG and biomarkers together augment the prediction of cardiac fibrosis in participants who are free of known CVD. This is a cross-sectional analysis in the MESA (Multiethnic Study of Atherosclerosis) study at visit 5 (2010 to 2012), with measurements of biomarkers (cardiac troponin T and growth differentiation factor-15), gadolinium-enhanced cardiac magnetic resonance imaging, and ECG. Logistic regression associations of ECG measures with cardiac magnetic resonance surrogates of fibrosis (highest quartile extracellular volume [interstitial fibrosis] and late gadolinium enhancement [replacement fibrosis]) were adjusted for demographics and risk factors. Using the C-statistic, we evaluated whether adding ECG measures and biomarkers to clinical characteristics improved the prediction of either type of fibrosis. There were 1,170 eligible participants (aged 67.1 ± 8.6 years). Among the ECG measures, QRS duration (odds ratio [OR] 1.41 per 10 ms, 95% confidence interval [CI] 1.10 to 1.81), major ST-T abnormalities (OR 3.03, 95%CI 1.20, 7.65), and abnormal QRS-T angle (OR 6.32, 95%CI 3.00, 13.33) were associated with replacement fibrosis, whereas only abnormal QRS-T angle (OR 3.05, 95%CI,1.69, 5.48) was associated with interstitial fibrosis. ECG markers, in addition to clinical characteristics, improved the prediction of replacement fibrosis (p = 0.002) but not interstitial fibrosis. The addition of cardiac troponin T and growth differentiation factor-15 to the ECG findings did not significantly improve the model discrimination for either type of cardiac fibrosis. In CVD free participants, simple ECG measures are associated with replacement fibrosis and interstitial fibrosis. The addition of these measures improves identification of replacement but not interstitial fibrosis. These findings may help refine the identification of myocardial scar in the general population.
| Errataetall: |
CommentIn: Am J Cardiol. 2023 Nov 1;206:372-374. - PMID 37689495 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:204 |
|---|---|
| Enthalten in: |
The American journal of cardiology - 204(2023) vom: 01. Okt., Seite 287-294 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ilkhanoff, Leonard [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 04.09.2023 Date Revised 10.10.2023 published: Print-Electronic CommentIn: Am J Cardiol. 2023 Nov 1;206:372-374. - PMID 37689495 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.amjcard.2023.07.041 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360665330 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360665330 | ||
| 003 | DE-627 | ||
| 005 | 20231226083509.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.amjcard.2023.07.041 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1202.xml |
| 035 | |a (DE-627)NLM360665330 | ||
| 035 | |a (NLM)37567020 | ||
| 035 | |a (PII)S0002-9149(23)00589-1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ilkhanoff, Leonard |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Electrocardiographic Associations of Cardiac Biomarkers and Cardiac Magnetic Resonance Measures of Fibrosis in the Multiethnic Study of Atherosclerosis (MESA) |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.09.2023 | ||
| 500 | |a Date Revised 10.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Am J Cardiol. 2023 Nov 1;206:372-374. - PMID 37689495 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a Abnormalities in myocardial substrate, including diffuse and replacement fibrosis, increase the risk of cardiovascular disease (CVD). Data are sparse on whether electrocardiogram (ECG) measures, coupled with circulating biomarkers, may aid in identifying cardiac fibrosis. This study aimed to determine whether 12-lead ECG and biomarkers together augment the prediction of cardiac fibrosis in participants who are free of known CVD. This is a cross-sectional analysis in the MESA (Multiethnic Study of Atherosclerosis) study at visit 5 (2010 to 2012), with measurements of biomarkers (cardiac troponin T and growth differentiation factor-15), gadolinium-enhanced cardiac magnetic resonance imaging, and ECG. Logistic regression associations of ECG measures with cardiac magnetic resonance surrogates of fibrosis (highest quartile extracellular volume [interstitial fibrosis] and late gadolinium enhancement [replacement fibrosis]) were adjusted for demographics and risk factors. Using the C-statistic, we evaluated whether adding ECG measures and biomarkers to clinical characteristics improved the prediction of either type of fibrosis. There were 1,170 eligible participants (aged 67.1 ± 8.6 years). Among the ECG measures, QRS duration (odds ratio [OR] 1.41 per 10 ms, 95% confidence interval [CI] 1.10 to 1.81), major ST-T abnormalities (OR 3.03, 95%CI 1.20, 7.65), and abnormal QRS-T angle (OR 6.32, 95%CI 3.00, 13.33) were associated with replacement fibrosis, whereas only abnormal QRS-T angle (OR 3.05, 95%CI,1.69, 5.48) was associated with interstitial fibrosis. ECG markers, in addition to clinical characteristics, improved the prediction of replacement fibrosis (p = 0.002) but not interstitial fibrosis. The addition of cardiac troponin T and growth differentiation factor-15 to the ECG findings did not significantly improve the model discrimination for either type of cardiac fibrosis. In CVD free participants, simple ECG measures are associated with replacement fibrosis and interstitial fibrosis. The addition of these measures improves identification of replacement but not interstitial fibrosis. These findings may help refine the identification of myocardial scar in the general population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a cardiac biomarkers | |
| 650 | 4 | |a cardiac magnetic resonance | |
| 650 | 4 | |a electrocardiography | |
| 650 | 7 | |a Gadolinium |2 NLM | |
| 650 | 7 | |a AU0V1LM3JT |2 NLM | |
| 650 | 7 | |a Troponin T |2 NLM | |
| 650 | 7 | |a Contrast Media |2 NLM | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Growth Differentiation Factors |2 NLM | |
| 700 | 1 | |a Qian, Xiaoxiao |e verfasserin |4 aut | |
| 700 | 1 | |a Lima, Joao A |e verfasserin |4 aut | |
| 700 | 1 | |a Tran, Henry |e verfasserin |4 aut | |
| 700 | 1 | |a Soliman, Elsayed Z |e verfasserin |4 aut | |
| 700 | 1 | |a Yeboah, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Seliger, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a deFilippi, Christopher R |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The American journal of cardiology |d 1958 |g 204(2023) vom: 01. Okt., Seite 287-294 |w (DE-627)NLM000025364 |x 1879-1913 |7 nnns |
| 773 | 1 | 8 | |g volume:204 |g year:2023 |g day:01 |g month:10 |g pages:287-294 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.amjcard.2023.07.041 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 204 |j 2023 |b 01 |c 10 |h 287-294 | ||