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Circ Cardiovasc Imaging. Author manuscript; available in PMC 2017 August 01. Published in final edited form as: Circ Cardiovasc Imaging. 2016 August ; 9(8): . doi:10.1161/CIRCIMAGING.115.004431.

Echocardiographic Predictors of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study

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Suma H. Konety, MD, MS1,*, Ryan J. Koene, MD1,*, Faye L. Norby, MS, MPH2, Tony Wilsdon, MS3, Alvaro Alonso, MD, PhD4, David Siscovick, MD, MPH5,6, Nona Sotoodehnia, MD, MPH5,6, John Gottdiener, MD7, Ervin R. Fox, MD8, Lin Y. Chen, MD, MS1, Selcuk Adabag, MD, MS9, and Aaron R. Folsom, MD, MPH2 1Cardiovascular 2Division

Division, University of Minnesota, Minneapolis, MN

of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN

3Department

of Biostatistics, University of Washington, Seattle, WA

4Department

of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA

5Department

of Epidemiology, University of Washington, Seattle, WA

6Cardiovascular

Health Research Unit, Department of Medicine, University of Washington,

Seattle, WA 7University

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8Division

of Maryland Hospital, Baltimore, MD

of Cardiology, University of Mississippi, Jackson, MS

9Cardiovascular

Division, Minneapolis VA Healthcare System, Minneapolis, MN

Abstract Background—This study assessed the echocardiographic predictors of sudden cardiac death (SCD) within two population-based cohorts.

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Methods and Results—Echocardiograms were obtained on 2383 participants (1993–95) from the Atherosclerosis Risk in Communities (ARIC) Study (100% African-American) and 5366 participants (1987–89 and 1994–95) from the Cardiovascular Health Study (CHS). The main outcome was physician-adjudicated SCD. We used Cox proportional hazards models with incident coronary heart disease (CHD) and heart failure as time-dependent covariates to assess the association between echocardiographic variables and SCD, adjusting for Framingham risk score (FRS) variables, CHD, and renal function. Cohort-specific results were meta-analyzed. During a median follow-up of 7.3 years and 13.1 years, 44 ARIC Study and 275 CHS participants had SCD, respectively. In the meta-analyzed results, the adjusted hazard ratios (95% confidence intervals)

Correspondence to: Suma H. Konety, MD, MS, Cardiovascular Division, University of Minnesota, 420 Delaware Street SE, MMC 508, Minneapolis, MN 55455, [email protected]. *SK and RK contributed equally to the manuscript Disclosures None.

Konety et al.

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for predictors of SCD were 3.07 (2.29–4.11) for reduced left ventricular ejection fraction (LVEF); 1.85 (1.36–2.52) for mitral annular calcification; 1.64 (1.07–2.51) for mitral E/A >1.5 and 1.52 (1.14–2.02) for mitral E/A