TY - JOUR
T1 - Whole body cardiovascular MRI for the comparison of atherosclerotic burden and cardiac remodelling in healthy South Asian and European adults
AU - Weir-McCall, Jonathan
AU - Cassidy, Deirdre B.
AU - Belch, Jill J. F.
AU - Gandy, Stephen J.
AU - Houston, J. Graeme
AU - Lambert, Matthew A.
AU - Littleford, Roberta C.
AU - Rowland, Janice
AU - Struthers, Allan D.
AU - Khan, Faisel
N1 - The present study was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. JRWM is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (grant no. WT 085664) in the form of a clinical research fellowship. Neither group had any role in study design, the collection, analysis and interpretation of data; in the writing of the article; nor in the decision to submit the article for publication.
PY - 2016
Y1 - 2016
N2 - OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20% as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.
AB - OBJECTIVES: To determine the feasibility of using whole body cardiovascular MRI (WB-CVMR) to compare South Asians (SA) - a population known to have a higher risk of cardiovascular disease (CVD) but paradoxically lower prevalence of peripheral arterial disease (PAD) - and Western Europeans (WE).METHODS: 19 SA and 38 age, gender and BMI matched WE were recruited. All were ≥40 years, free from CVD and with a 10-year risk of CVD <20% as assessed by the ATPIII risk score. WB-CVMR was performed, comprising a whole body angiogram (WBA) and cardiac MR (CMR), on a 3T MRI scanner following dual phase injection of gadolinium based contrast agent. A standardized atherosclerotic score (SAS) was calculated from the WBA, while indexed left ventricular mass and volumes were calculated from the CMR.RESULTS: SAs exhibited a significantly lower iliofemoral atheroma burden (regional SAS 0.0±0.0 vs 1.9±6.9, p=0.048) and a trend towards lower overall atheroma burden (WB SAS 0.7±0.8 vs 1.8±2.3, p=0.1). They had significantly lower indexed left ventricular mass (46.9±11.8 vs 56.9±13.4ml/m(2), p=0.008), end diastolic volume (63.9±10.4 vs 75.2±11.4ml/m(2), p=0.001), end systolic volume (20.5±6.1 vs 24.6±6.8ml/m(2), p=0.03) and stroke volume (43.4±6.6 vs 50.6±7.9ml/m(2), p=0.001), but with no significant difference in ejection fraction, mass-volume ratio or global functioning index. These differences persisted after accounting for CVD risk factors.CONCLUSIONS: Whole body cardiovascular MRI (WB-CVMR) can quantify cardiac and atheroma burden, and can detect differences in these metrics between ethnic groups that, if validated, may suggest that the paradoxical high risk of CVD compared with PVD risk may be due to an adverse cardiac haemodynamic status incurred by the smaller heart rather than atherosclerosis.ADVANCES IN KNOWLEDGE: WB-CVMR can be used to stratify and compare disease between ethnicities.
U2 - 10.1259/bjr.20160342
DO - 10.1259/bjr.20160342
M3 - Article
C2 - 27351693
SN - 0007-1285
VL - 89
SP - 1
EP - 8
JO - British Journal of Radiology
JF - British Journal of Radiology
IS - 1065
M1 - 20150887
ER -