Comparing incidence of heart failure in individuals with enlarged cardiac chambers versus diabetes.
Authors
Affiliations (21)
Affiliations (21)
- HeartLung.AI, Houston, TX 77021, USA.
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY 14853, USA.
- University of Basel, Switzerland, Basel 4001, Switzerland.
- Tustin Teleradiology, Tustin, CA 92780, USA.
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
- Kravis Center for Clinical Cardiovascular Health, Mount Sinai Fuster Heart Hospital, New York, NY 10029, USA.
- Department of Epidemiology and Biostatistics, Wen School of Public Health, University of California, Irvine, USA.
- The Lundquist Institute, CA 90502, USA.
- Houston Methodist Hospital, Houston, TX 77030, USA.
- Department of Radiology, University of California Irvine, CA 92697, USA.
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA.
- Computational Biomedicine Laboratory, Department of Computer Science, University of Houston, Houston, TX, USA.
- Division of Cardiology, Michigan State University, East Lansing, MI 48823, USA.
- Dept of Radiology, University Medical Center Groningen, GZ 9713, the Netherlands.
- University of Houston, Houston, TX 77030, USA.
- University of Louisville, Louisville, KY 40292, USA.
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20824, USA.
- Huntington Medical Research Institutes, Pasadena, CA 91105, USA.
- Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA.
- Heart Disease Prevention Program, Mary and Steve Wen Cardiovascular Division, University of California Irvine, CA 92697, USA.
Abstract
Opportunistic cardiac chamber volumetry derived from coronary artery calcium (CAC) scans using the AI-CVD platform predicts heart failure (HF) independent of conventional risk factors. Type 2 diabetes mellitus (T2DM), which classifies individuals as Stage A HF, is associated with chamber enlargement; however, the HF risk associated with chamber enlargement in the absence of T2DM has not been characterized. We analyzed left atrial (LA) and left ventricular (LV) volumes and mass, indexed to body surface area, using AI-CVD chamber volumetry of 7585 asymptomatic participants in the pooled cohort of Multi-Ethnic Study of Atherosclerosis (MESA) and Framingham Heart Study (FHS) second, and third generation (MESA & FHS; mean age 62.7 ± 14.6 years, 48.6 % male, 10.6 % with T2DM). Chambers were classified as enlarged (≥95th) or normal (<50th percentile). Cox regression and Kaplan-Meier analyses with log-rank tests were performed. Over a median follow-up of 17.1 years, 438 HF events occurred. Individuals without T2DM, with enlarged chambers had HF incidence rates comparable to or higher than individuals with T2DM and normal chambers: LA volume 16.4 vs 8.7 (<i>p</i> = 0.001), LV volume 8.1 vs 8.9 (<i>p</i> = 0.66), and LV mass 10.1 vs 8.9 (<i>p</i> = 0.55) per 1000 person-years. After multivariable adjustment, compared with normal chambers, enlarged LA (HR 2.5[1.9-3.3]), LV (HR 3.5[2.3-5.4]), and LV mass (HR 3.2[2.2-4.9]) remained independently associated with HF in individuals without T2DM. AI-derived cardiac chamber enlargement measured in CAC scans is associated with HF incidence in individuals without T2DM, supporting its potential utility in HF risk stratification.