Background-Left ventricular wall motion (WM) abnormalities have recognized prognostic significance in patients with coronary or other heart diseases; however, whether abnormal WM predicts adverse events in adults without overt cardiovascular disease has not been assessed. Our objective was to determine whether echocardiographic WM abnormalities predict subsequent cardiovascular events in a population-based sample. Methods and Results-Participants (nϭ2864, mean age 60Ϯ8 years, 64% women) without

more »

... clinically evident cardiovascular disease in the second Strong Heart Study examination who had complete echocardiographic WM assessment were studied. Echocardiographic assessment revealed that 5% of participants (nϭ140) had focal hypokinesia, and 1.5% (nϭ42) had WM abnormalities. Relationships between WM abnormalities and fatal and nonfatal cardiovascular events (including myocardial infarction, stroke, coronary artery disease, and heart failure; nϭ554) and cardiovascular death (nϭ182) during 8Ϯ2 years follow-up were examined. In Cox regression, after adjustment for age, gender, waist/hip ratio, systolic blood pressure, and diabetes mellitus, segmental WM abnormalities were associated with a 2.5-fold higher risk of cardiovascular events and a 2.6-fold higher risk of cardiovascular death (both PϽ0.0001). In similar multivariable models, global WM abnormalities were associated with a 2.4-fold higher risk of cardiovascular events (Pϭ0.001) and a 3.4-fold higher risk of cardiovascular death (Pϭ0.003). Conclusions-Echocardiographic left ventricular WM abnormalities in adults without overt cardiovascular disease are associated with 2.4-to 3.4-fold higher risks of cardiovascular morbidity and mortality, independent of established risk factors. (Circulation. 2007;116:143-150.)