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Cardiovascular Function in Multi-Ethnic Study of Atherosclerosis: Normal Values by Age, Sex, and Ethnicity

¹ Department of Radiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD.
² Department of Epidemiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD.
³ Department of Radiology, UCLA School of Medicine, Los Angeles, CA.
⁴ Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC.
⁵ Department of Radiology, University of Minnesota, Minneapolis, MN.
⁶ Department of Radiology, College of Physicians and Surgeons of Columbia University, New York, NY.
⁷ National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
⁸ Departments of Radiology and Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N Wolfe St., Baltimore, MD 21287.

OBJECTIVE. MRI provides accurate and high-resolution measurements of cardiac anatomy and function. The purpose of this study was to describe the imaging protocol and normal values of left ventricular (LV) function and mass in the Multi-Ethnic Study of Atherosclerosis (MESA).

SUBJECTS AND METHODS. Eight hundred participants (400 men, 400 women) in four age strata (45–54, 55–64, 65–74, 75–84 years) were chosen at random. Participants with the following known cardiovascular risk factors were excluded: current smoker, systolic blood pressure > 140 mm Hg, diastolic blood pressure > 90 mm Hg, fasting glucose > 110 mg/dL, total cholesterol > 240 mg/dL, and high-density lipoprotein (HDL) cholesterol < 40 mg/dL. Cardiac MR images were analyzed using MASS software (version 4.2). Mean values, SDs, and correlation coefficients in relationship to patient age were calculated.

RESULTS. There were significant differences in LV volumes and mass between men and women. LV volumes were inversely associated with age (p < 0.05) for both sexes except for the LV end-systolic volume index. For men, LV mass was inversely associated with age (slope = -0.72 g/year, p = 0.0021), but LV mass index was not associated with age (slope = -0.179 g/m²/year, p = 0.075). For women, LV mass (slope = -0.15 g/year, p = 0.30) and LV mass index (slope = 0.0044 g/m²/year, p = 0.95) were not associated with age. LV mass was the largest in the African-American group (men, 181.6 ± 35.8 [SD] g; women, 128.8 ± 28.1 g) and was smallest in the Asian-American group (men, 129.1 ± 20.0 g; women, 89.4 ± 13.3 g).

CONCLUSION. The normal LV differs in volume and mass between sexes and among certain ethnic groups. When indexed by body surface area, LV mass was independent of age for both sexes. Studies that assess cardiovascular risk factors in relationship to cardiac function and structure need to account for these normal variations in the population.

Keywords: atherosclerosis • cardiac function • cardiac imaging • ejection fraction • heart • left ventricle • left ventricle mass • MRI

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