Association between myocardial work indices and cardiovascular events according to hypertension in the general population.
Eur Heart J Cardiovasc Imaging
; 25(3): 413-424, 2024 Feb 22.
Article
em En
| MEDLINE
| ID: mdl-37930752
ABSTRACT
AIMS:
Pressure-strain loop (PSL) analysis is a novel echocardiographic tool capable of assessing myocardial work non-invasively. In this study, we aim to evaluate the prognostic value of myocardial work indices in the general population. METHODS ANDRESULTS:
This was a prospective community-based cohort study (n = 4466). PSL analyses were performed to acquire global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency (GWE). The endpoint was a composite of heart failure or cardiovascular death (HF/CVD). Survival analysis was applied. A total of 3932 participants were included in this analysis (median age 58 years, 43% men). Of these, 124 (3%) experienced the outcome during a median follow-up period of 3.5 years [interquartile range (IQR) 2.6-4.4 years]. Hypertension significantly modified the association between all work indices and outcome (P for interaction < 0.05), such that work indices posed a higher risk of outcome in non-hypertensive than in hypertensive participants. After adjusting for Atherosclerosis Risk in Communities (ARIC)-HF risk variables, all work indices predicted outcome in non-hypertensive participants, but only GWI, GCW, and GWE predicted outcome in hypertensive participants [GWI hazard ratio (HR) = 1.12 (1.07-1.16), per 100â mmHg% decrease; GCW HR = 1.12 (1.08-1.17), per 100â mmHg% decrease; GWE HR = 1.08 (1.04-1.12), per 1% decrease]. Only GWE significantly increased C-statistics when added to ARIC-HF risk variables in hypertensive participants (C-stat 0.865 vs. 0.877, P for increment = 0.003).CONCLUSION:
Hypertension modifies the association between myocardial work indices and HF/CVD in the general population. All work indices are associated with outcome in normotensive participants. GWI, GCW, and GWE are independently associated with outcome in hypertension, but only GWE improves risk prediction.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aterosclerose
/
Insuficiência Cardíaca
/
Hipertensão
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Dinamarca