학술논문
Association between myocardial work indices and cardiovascular events according to hypertension in the general population.
Document Type
Academic Journal
Author
Olsen FJ; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Skaarup KG; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Lassen MCH; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Johansen ND; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Jensen GB; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Schnohr P; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Marott JL; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Søgaard P; Department of Cardiology, Copenhagen University Hospital-North Zealand, Dyrehavevej 29, Hilleroed 3400, Denmark.; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Gislason G; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Svendsen JH; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.; Møgelvang R; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.; Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark.; Aalen JM; Institute for Surgical Research, Oslo University Hospital and University of Oslo, Rikshospitalet, Sognsvannsveien 20, Oslo 0372, Norway.; Smiseth OA; Institute for Surgical Research, Oslo University Hospital and University of Oslo, Rikshospitalet, Sognsvannsveien 20, Oslo 0372, Norway.; Remme EW; Institute for Surgical Research, Oslo University Hospital and University of Oslo, Rikshospitalet, Sognsvannsveien 20, Oslo 0372, Norway.; The Intervention Centre, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo 0372, Norway.; Biering-Sørensen T; Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 1, Hellerup 2900, Denmark.; The Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark.
Source
Publisher: Oxford University Press Country of Publication: England NLM ID: 101573788 Publication Model: Print Cited Medium: Internet ISSN: 2047-2412 (Electronic) Linking ISSN: 20472404 NLM ISO Abbreviation: Eur Heart J Cardiovasc Imaging Subsets: MEDLINE
Subject
Language
English
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 and Results: 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 100 mmHg% decrease; GCW: HR = 1.12 (1.08-1.17), per 100 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.
Competing Interests: Conflict of interest: T.B.-S.: Steering Committee member of the Amgen financed GALACTIC-HF trial; Steering Committee of the Boston Scientific financed LUX-Dx TRENDS trial; Advisory Board: Sanofi Pasteur. Advisory Board: Amgen; Speaker Honorarium: Novartis; Speaker Honorarium: Sanofi Pasteur; Research grant: GE Healthcare; Research grant: Sanofi Pasteur. O.A.S.: co-inventor of ‘Method for myocardial segment work analysis’, which was used to calculate myocardial work indices. J.H.S.: advisory board member for Medtronic and unrestricted research grants from Medtronic outside this work. The organizations had no role in any aspect of the study. The remaining authors do not have any potential conflicts of interest to disclose.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Methods and Results: 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 100 mmHg% decrease; GCW: HR = 1.12 (1.08-1.17), per 100 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.
Competing Interests: Conflict of interest: T.B.-S.: Steering Committee member of the Amgen financed GALACTIC-HF trial; Steering Committee of the Boston Scientific financed LUX-Dx TRENDS trial; Advisory Board: Sanofi Pasteur. Advisory Board: Amgen; Speaker Honorarium: Novartis; Speaker Honorarium: Sanofi Pasteur; Research grant: GE Healthcare; Research grant: Sanofi Pasteur. O.A.S.: co-inventor of ‘Method for myocardial segment work analysis’, which was used to calculate myocardial work indices. J.H.S.: advisory board member for Medtronic and unrestricted research grants from Medtronic outside this work. The organizations had no role in any aspect of the study. The remaining authors do not have any potential conflicts of interest to disclose.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)