Left ventricular parameters and mass indexing methods in cardiac magnetic resonance imaging in prediction of major adverse cardiovascular events and mortality

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Background: Increased left ventricular mass (LVM) is a predictor of adverse outcomes. We investigated which cardiac magnetic resonance (CMR) imaging parameters and LVM indexing methods are associated with major adverse cardiovascular events (MACEs) and mortality. Methods: In this exploratory analysis, we included patients with known cardiovascular diseases who underwent CMR. Left ventricular hypertrophy (LVH) was defined as LVM >148 g for men or >96 g for women. Moreover, various LVM indexing methods were studied including indexing to body surface area (BSA) with cut-off values determined by the Multi-Ethnic Study of Atherosclerosis (MESA). The data on the MACE and mortality occurrence in the 6-year follow-up were collected. Results: . 79.6 (62.0-96.1) mL, P=0.004]. In multivariable regression analysis low LVSV independently predicted MACE [hazard ratio (HR): 0.97; 95% confidence interval (CI): 0.94-1.00, P=0.02], while increased LVM/BSA (MESA) was an independent predictor of all-cause mortality (HR: 11.03; 95% CI: 1.22-99.73, P=0.03). However, after correction for multiple testing across eight LVH definitions in univariable analyses, none was statistically significant. Conclusions: Selected CMR-derived parameters, particularly LVSV and LVM indexed using MESA-derived cut-off values may be associated with adverse clinical outcomes. Further research on predictive meaning of CMR-derived parameters, utilizing larger, adequately powered studies is needed.

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