Myocardial disease may explain higher event rates in blacks

Monday, November 26 | 11:40 a.m.-11:50 a.m. | SSC02-08 | Room S504AB
Generally higher myocardial measurements may explain the greater prevalence of cardiac events in blacks compared with whites, according to research from the Medical University of South Carolina, Heidelberg University, and three other centers.

"Previous studies have shown higher mortality and hospitalization rates due to cardiac heart failure (CHF) in African-American patients compared to white populations," Dr. Paul Apfaltrer from the Heidelberg University told AuntMinnie.com. "Discrepancies in the prevalence and consequences of CHF between African-Americans and whites have been attributed to race- and ethnicity-related differences in the prevalence of coexisting conditions such as hypertension and diabetes mellitus, the quality and availability of medical care, and disparities in socioeconomic factors. However, potentially, differences in cardiac structure and function may explain part of the disparity in risk of coronary heart disease."

The study aimed to compare CT-derived cardiac measures between black and white patients with acute chest pain to test the hypothesis that a higher rate of cardiac events among blacks may be related to increased incidence of myocardial disease.

The researchers examined 333 patients (mean age, 54 years), including 163 blacks and 170 whites. They recorded myocardial mass, left ventricular ejection fraction, left ventricular end-systolic and end-diastolic volumes, septal wall thickness, and cardiac chamber diameters.

Blacks had a larger myocardial mass than whites (174.4 ± 57.8 g versus 157.3 ± 55.2 g; p < 0.01), while septal wall thickness was slightly greater, mainly due to results in women. Most other measures were also higher in blacks, and the relationship between race and myocardial parameters remained significant after adjusting for cardiovascular risk factors.

"CT-derived myocardial measures differ between symptomatic white and black patients, suggesting a differential relationship between myocardial adaptation and heart disease by race," according to Apfaltrer. Population-based outcome studies are needed to determine the prognostic value of these findings, he added.

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