Mats Christian Højbjerg Lassen1,2, Sofie Reumert Biering-Sørensen1,3, Flemming Javier Olsen1, Kristoffer Grundtvig Skaarup1, Kirsten Tolstrup2, Atif Nazier Qasim2, Rasmus Møgelvang1,3, Jan Skov Jensen1,3,4, Tor Biering-Sørensen1,3,5. 1. Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Niels Andersens vej 65, Copenhagen, Denmark. 2. Division of Cardiology, University of California San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA, USA. 3. The Copenhagen City Heart Study, Frederiksberg Hospital, University of Copenhagen, Nordre Fasanvej 57, Copenhagen, Denmark. 4. Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3b, Copenhagen, Denmark. 5. Department of Medicine, Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA.
Abstract
Aims: It has previously been demonstrated that the ratio of early mitral inflow velocity to global diastolic strain rate (E/e'sr) is a significant predictor of cardiac events in specific patient populations. The utility of this measurement to predict cardiovascular events in a general population has not been evaluated. Methods and results: A total of 1238 participants in a general population study underwent a health examination including echocardiography where global longitudinal strain (GLS) and E/e'sr were determined. The primary endpoint was the composite of incident heart failure (HF), acute myocardial infarction (AMI) or cardiovascular death (CVD). During follow-up (median 11 years), 140 (11.3%) participants reached the composite endpoint. E/e'sr was associated with adverse outcome [HR 1.17 95% CI (1.13-1.21); P < 0.001, per 10 cm increase]. After multivariable adjustment for echocardiographic and clinical parameters, E/e'sr remained an independent predictor of the composite endpoint [HR 1.08, 95% CI (1.02-1.13); P = 0.003] as opposed to E/e' [HR 1.03, 95% CI (0.99-1.06); P = 0.11 per 1 unit increase]. Global longitudinal strain modified the relationship between E/e'sr and outcome (P for interaction = 0.015). E/e'sr was a stronger predictor in participants with good systolic function as determined by GLS (GLS > 18%) after multivariable adjustment, when compared to participants with reduced systolic function (GLS < 18%) [HR 1.28 95% CI (1.06-1.54); P = 0.011, and HR 1.08 95% CI (1.02-1.14); P = 0.012, respectively). E/e'sr provided incremental information [Harrell's C-index: 0.839 (0.81-0.87) vs. 0.844 (0.82-0.87); P = 0.045] beyond the SCORE risk chart. Conclusion: In the general population, E/e'sr provides independent and incremental prognostic information regarding cardiovascular morbidity and mortality. Additionally, E/e'sr is a stronger predictor of cardiac events than E/e'.
Aims: It has previously been demonstrated that the ratio of early mitral inflow velocity to global diastolic strain rate (E/e'sr) is a significant predictor of cardiac events in specific patient populations. The utility of this measurement to predict cardiovascular events in a general population has not been evaluated. Methods and results: A total of 1238 participants in a general population study underwent a health examination including echocardiography where global longitudinal strain (GLS) and E/e'sr were determined. The primary endpoint was the composite of incident heart failure (HF), acute myocardial infarction (AMI) or cardiovascular death (CVD). During follow-up (median 11 years), 140 (11.3%) participants reached the composite endpoint. E/e'sr was associated with adverse outcome [HR 1.17 95% CI (1.13-1.21); P < 0.001, per 10 cm increase]. After multivariable adjustment for echocardiographic and clinical parameters, E/e'sr remained an independent predictor of the composite endpoint [HR 1.08, 95% CI (1.02-1.13); P = 0.003] as opposed to E/e' [HR 1.03, 95% CI (0.99-1.06); P = 0.11 per 1 unit increase]. Global longitudinal strain modified the relationship between E/e'sr and outcome (P for interaction = 0.015). E/e'sr was a stronger predictor in participants with good systolic function as determined by GLS (GLS > 18%) after multivariable adjustment, when compared to participants with reduced systolic function (GLS < 18%) [HR 1.28 95% CI (1.06-1.54); P = 0.011, and HR 1.08 95% CI (1.02-1.14); P = 0.012, respectively). E/e'sr provided incremental information [Harrell's C-index: 0.839 (0.81-0.87) vs. 0.844 (0.82-0.87); P = 0.045] beyond the SCORE risk chart. Conclusion: In the general population, E/e'sr provides independent and incremental prognostic information regarding cardiovascular morbidity and mortality. Additionally, E/e'sr is a stronger predictor of cardiac events than E/e'.
Authors: Mats C H Lassen; Atif N Qasim; Tor Biering-Sørensen; Jacob L T Reeh; Terry Watnick; Stephen L Seliger; Huanwen Chen; Mariem A Sawan; Daniel Nguyen; Yongfang Li; Susie N Hong; Meyeon Park Journal: BMC Nephrol Date: 2019-08-16 Impact factor: 2.388
Authors: Sun Ryoung Choi; Young-Ki Lee; Hayne Cho Park; Do Hyoung Kim; AJin Cho; Juhee Kim; Kyu Sang Yun; Jung-Woo Noh; Min-Kyung Kang Journal: Kidney Res Clin Pract Date: 2021-11-30