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dc.contributor.authorXanthakis, Vanessaen_US
dc.contributor.authorLarson, Martin G.en_US
dc.contributor.authorWollert, Kai C.en_US
dc.contributor.authorAragam, Jayashrien_US
dc.contributor.authorCheng, Susanen_US
dc.contributor.authorHo, Jenniferen_US
dc.contributor.authorCoglianese, Erinen_US
dc.contributor.authorLevy, Danielen_US
dc.contributor.authorColucci, Wilson S.en_US
dc.contributor.authorMichael Felker, G.en_US
dc.contributor.authorBenjamin, Emelia J.en_US
dc.contributor.authorJanuzzi, James L.en_US
dc.contributor.authorWang, Thomas J.en_US
dc.contributor.authorVasan, Ramachandran S.en_US
dc.date.accessioned2014-03-11T13:26:39Z
dc.date.issued2013en_US
dc.identifier.citationXanthakis, V., M. G. Larson, K. C. Wollert, J. Aragam, S. Cheng, J. Ho, E. Coglianese, et al. 2013. “Association of Novel Biomarkers of Cardiovascular Stress With Left Ventricular Hypertrophy and Dysfunction: Implications for Screening.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 2 (6): e000399. doi:10.1161/JAHA.113.000399. http://dx.doi.org/10.1161/JAHA.113.000399.en
dc.identifier.issn2047-9980en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11879589
dc.description.abstractBackground: Currently available screening tools for left ventricular (LV) hypertrophy (LVH) and systolic dysfunction (LVSD) are either expensive (echocardiography) or perform suboptimally (B‐type natriuretic peptide [BNP]). It is unknown whether newer biomarkers are associated with LVH and LVSD and can serve as screening tools. Methods and Results: We studied 2460 Framingham Study participants (mean age 58 years, 57% women) with measurements of biomarkers mirroring cardiac biomechanical stress (soluble ST‐2 [ST2], growth differentiation factor‐15 [GDF‐15] and high‐sensitivity troponin I [hsTnI]) and BNP. We defined LVH as LV mass/height2 ≥the sex‐specific 80th percentile and LVSD as mild/greater impairment of LV ejection fraction (LVEF) or a fractional shortening <0.29. Adjusting for standard risk factors in logistic models, BNP, GDF‐15, and hsTnI were associated with the composite echocardiographic outcome (LVH or LVSD), odds ratios (OR) per SD increment in log‐biomarker 1.29, 1.14, and 1.18 (95% CI: 1.15 to 1.44, 1.004 to 1.28, and 1.06 to 1.31), respectively. The C‐statistic for the composite outcome increased from 0.765 with risk factors to 0.770 adding BNP, to 0.774 adding novel biomarkers. The continuous Net Reclassification Improvement was 0.212 (95% CI: 0.119 to 0.305, P<0.0001) after adding the novel biomarkers to risk factors plus BNP. BNP was associated with LVH and LVSD in multivariable models, whereas GDF‐15 was associated with LVSD (OR 1.41, 95% CI: 1.16 to 1.70), and hsTnI with LVH (OR 1.22, 95% CI: 1.09 to 1.36). ST2 was not significantly associated with any outcome. Conclusions: Our community‐based investigation suggests that cardiac stress biomarkers are associated with LVH and LVSD but may have limited clinical utility as screening tools.en
dc.language.isoen_USen
dc.publisherBlackwell Publishing Ltden
dc.relation.isversionofdoi:10.1161/JAHA.113.000399en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886765/pdf/en
dash.licenseLAAen_US
dc.subjectEpidemiologyen
dc.subjectbiomarkersen
dc.subjectechocardiographyen
dc.subjectheart failureen
dc.subjecthypertrophyen
dc.subjectscreeningen
dc.titleAssociation of Novel Biomarkers of Cardiovascular Stress With Left Ventricular Hypertrophy and Dysfunction: Implications for Screeningen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalJournal of the American Heart Association: Cardiovascular and Cerebrovascular Diseaseen
dash.depositing.authorAragam, Jayashrien_US
dc.date.available2014-03-11T13:26:39Z
dc.identifier.doi10.1161/JAHA.113.000399*
dash.authorsorderedfalse
dash.contributor.affiliatedAragam, Jayashri
dash.contributor.affiliatedCheng, Susan
dash.contributor.affiliatedJanuzzi, James


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