부산대학교 도서관

Introduction: Peak systolic strain rate (SrS) reflecting the maximal acceleration of the systolic deformation during systole derived from speckle tracking echocardiography has been demonstrated to be a significant predictor of cardiovascular outcomes in patients with myocardial infarction. However, the prognostic utility of SrS in individuals with low cardiovascular risk is unknown.Hypothesis: We hypothesized that SrS was associated with incident heart failure (HF) in the general population.Methods: The 5th Copenhagen City Heart Study is a prospective cohort study. All participants had echocardiography performed. Exclusion criteria were prevalent HF and inadequate image quality for SrS assessment. The multivariable Cox model included variables from the Atherosclerosis Risk In Communities (ARIC) HF risk score and left ventricular ejection fraction.Results: A total of 4,013 participants were included in the final study sample. The mean age was 56 years and 2,290 (57.1%) were female. The mean SrS was 1.11 s. During a median follow-up of 5.4 years, 101 participants (3%) developed HF. In multivariable analysis, decreasing SrS was significantly associated with HF (HR 1.32 (95% CI: 1.12; 1.56) p= 0.001) per s decrease) (Figure). The optimal cutoff value of SrS < 1.028 s was linked to a 4-fold risk of HF (HR 4.38 (95% CI: 2.92; 6.56). Incidence rate of HF was 2.4 per 1000 person-years (95% CI: 1.77; 3.36) when SrS ≥ 1.028 and 10.7 per 1000 person-years (95% CI: 8.35; 13.63) when SrS < 1.028. The cutoff had a sensitivity of 63.4% (95% CI: 53.2; 72.7), a specificity of 72.1% (95% CI: 70.6; 73.5), and a negative predictive value of 98.7% (95% CI: 98.2; 99.1). Finally, SrS added incremental value to the ARIC HF risk score with a net reclassification index of 0.264 (95% CI: 0.086; 0.415).Conclusions: SrS was significantly associated with the development of HF in the general population and provided incremental value to the ARIC HF risk score.