IJMEG Copyright © 2010-present. All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Int J Mol Epidemiol Genet 2011;2(4):391-400

Original Article
Biomarkers of inflammation and hemostasis associated with left ventricular
mass: The Multiethnic Study of Atherosclerosis (MESA)

Donna K Arnett, Robyn L McClelland, Alan Bank, David A Bluemke, Mary Cushman, Alexander J Szalai, Nishank Jain, Antoinette
S Gomes, Susan R Heckbert, W Gregory Hundley, João A Lima

Department of Epidemiology, University of Alabama at Birmingham, Birmingham; Department of Biostatistics, University
of Washington, Seattle; Saint Paul Heart Clinic, University of Minnesota, St. Paul; National Institute of Biomedical
Imaging and Bioengineering, Bethesda; Department of Medicine, University of Vermont, Burlington; Division
of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham; Department of
Radiology, UCLA School of Medicine, Los Angeles; Department of Epidemiology, University of Washington, Seattle;
Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem; Department of Cardiology,
Johns Hopkins University, Baltimore, USA.

Received November 14, 2011; accepted November 20, 2011; Epub November 28, 2011; Published December 15, 2011

Abstract: Purpose: Biomarkers of inflammation and hemostasis have been associated with left ventricular (LV) mass. We
studied relationships of C-reactive protein (CRP), interleukin-6 (IL6), D-dimer, soluble intercellular adhesion molecule-1
(sICAM-1), plasminogen activator inhibitor 1 (PAI-1), soluble thrombomodulin (sTM), soluble tumor necrosis factor type 1
receptor (sTNFR1), von Willebrand factor (vWF), soluble E-selectin (sE-selectin), factor VIII, fibrinogen, matrix metalloproteinase
3 (MMP3), and matrix metalloproteinase 9 (MMP9) with LV mass in an asymptomatic population. Multi-Ethnic Study of
Atherosclerosis participants underwent magnetic resonance imaging to characterize LV mass; biomarkers were measured
using standardized protocols (N=763 to 4979). Adjusted models were used to associate each biomarker with LV mass while
correcting for potential confounding. Findings: LV mass was associated with many biomarkers after adjustment for
demographic characteristics and traditional cardiovascular risk factors. Although the demographic and risk factor adjustments
attenuated the association of CRP and IL6 with LV mass, further adjustment for weight changed regression coefficients from
positive to negative for CRP and IL6 for LV mass. sTM, Factor VIII, and vWF were directly associated with LV mass in
fully-adjusted models. For sTNFR1, sICAM-1, Ddimer, fibrinogen, and PAI-1, adjustment for risk factors and weight rendered
associations with LV mass nonsignificant. Conclusions: In this large cohort free of clinical cardiovascular disease, several
hemostasis and inflammation markers were associated with LV mass. The unusual finding of a negative relationship of CRP
and IL6 with LV mass only after adjustment for weight suggests that the effects of inflammation on LV mass are strongly
influenced by obesity. (IJMEG1111003).

Key words: Left ventricle, biomarker, hemostasis, inflammation

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Address all correspondence to:
Dr. Donna K. Arnett
Department of Epidemiology
University of Alabama at Birmingham
Birmingham, AL, USA.
E-mail: arnett@uab.edu