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Cardiac structure and the QRISK cardiovascular risk prediction score: insights from the UK Biobank

Session Poster session 2

Speaker Ross Thomson

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Dimensions, Volumes and Mass
  • Session type : Poster Session

Authors : R J Thomson (London,GB), N Aung (London,GB), MM Sanghvi (London,GB), K Fung (London,GB), JM Paiva (London,GB), MY Khanji (London,GB), E Lukaschuk (Oxford,GB), V Carapella (Oxford,GB), SK Piechnik (Oxford,GB), SK Neubauer (Oxford,GB), SE Petersen (London,GB)

Authors:
R J Thomson1 , N Aung1 , MM Sanghvi1 , K Fung1 , JM Paiva1 , MY Khanji1 , E Lukaschuk2 , V Carapella2 , SK Piechnik2 , SK Neubauer2 , SE Petersen1 , 1Queen Mary University of London, William Harvey Research Institute - London - United Kingdom of Great Britain & Northern Ireland , 2University of Oxford Centre for Clinical Magnetic Resonance Research - Oxford - United Kingdom of Great Britain & Northern Ireland ,

Citation:
European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii329

Introduction

Cardiovascular disease is the leading cause of death globally. Efforts to reduce morbidity and mortality increasingly recognise the role of primary prevention strategies and the need to target interventions according to the risk profile of the individual patient. Cardiovascular risk prediction algorithms have therefore become an important tool in guiding evidence-based management.

QRISK is the risk prediction tool recommended by NICE in the United Kingdom. It combines a number of parameters to estimate an individual’s 10-year risk of cardiovascular disease. Although a number of studies have validated the algorithm’s risk prediction performance, none have examined the relationship between the risk score and cardiac structure as measured with cardiovascular magnetic resonance (CMR) imaging.

Methods

UK Biobank is a prospective cohort study of community participants in the United Kingdom. Individuals self-reported demographics and co-morbidities and underwent measurement of physical characteristics, and a subset underwent CMR imaging. CMR images were manually analysed to derive ventricular volumes and mass. The QRISK score was calculated according to the authors’ published algorithm.

The relationships between CMR-derived measures of cardiac structure and quintiles of QRISK score were modelled using multivariable linear regression with age, diastolic blood pressure, heart rate, alcohol consumption and physical activity as covariates. Individuals with established cardiovascular disease were excluded, and the analyses were stratified by sex.

Results

After adjustment for confounders higher QRISK score was associated with greater LV mass (2.21g per quintile of QRISK score for females; 3.45g per quintile for males) and greater LV mass-to-volume ratio (0.016 per quintile of QRISK score for males; 0.014 per quintile for females). In these preliminary analyses there was no association between ventricular volumes and QRISK score, except for an inverse relationship with RV end-systolic volume observed only in males.

Discussion

In a population of healthy participants QRISK score was associated with left ventricular mass and mass-to-volume ratio. These parameters have been shown previously to be strongly associated with cardiovascular morbidity and mortality. The relationships observed in this study provide insight into the changes taking place in the hearts of otherwise healthy individuals as their cardiovascular risk increases, and confirm the additional utility of the QRISK score in predicting deleterious changes in left ventricular structure, over and above the powerful influences of age and sex.

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