Abnormal myocardial deformation during stress echocardiography is predictive of mortality independent of left ventricular hypertrophy and myocardial ischaemia

Stanton, T., Bjork Ingul, C., Hare, J. L., Leano, R. and Marwick, T. (2008). Abnormal myocardial deformation during stress echocardiography is predictive of mortality independent of left ventricular hypertrophy and myocardial ischaemia. In: , Abstracts of the European Society of Cardiology Congress 2008. European Society of Cardiology Congress 2008, Munich, Germany, (279-279). 30 August - 3 September 2008.


Author Stanton, T.
Bjork Ingul, C.
Hare, J. L.
Leano, R.
Marwick, T.
Title of paper Abnormal myocardial deformation during stress echocardiography is predictive of mortality independent of left ventricular hypertrophy and myocardial ischaemia
Conference name European Society of Cardiology Congress 2008
Conference location Munich, Germany
Conference dates 30 August - 3 September 2008
Proceedings title Abstracts of the European Society of Cardiology Congress 2008   Check publisher's open access policy
Journal name European Heart Journal   Check publisher's open access policy
Place of Publication Oxford, England, U. K.
Publisher Oxford University Press
Publication Year 2008
Sub-type Published abstract
DOI 10.1093/eurheartj/ehn375
ISSN 0195-668X
1522-9645
Volume 29
Issue Suppl. 1
Start page 279
End page 279
Total pages 1
Language eng
Formatted Abstract/Summary Objective
To investigate whether the incremental value of myocardial deformation during dobutamine stress echocardiography (DSE) for the prediction of mortality is independent of left ventricular hypertrophy (LVH) and myocardial ischaemia.

Methods
231 consecutive individuals with normal resting left ventricular (LV) function undergoing DSE were studied. LV mass was calculated according to the American Society of Echocardiography (ASE) guidelines and indexed to height(m)2.7 (LVMI). LVH was designated as LVMI≥51g/m2.7. Myocardial ischaemia was defined on the basis of inducible wall motion abnormalities. Customized software was used to measure peak systolic Strain Rate (SR) in 18 myocardial segments and the mean calculated. Individuals were followed for allcause mortality for a mean of 5.4±1.4 years.

Results
Mean LVMI was 47.6±13.6g/m2.7 . 68 patients had ischaemia documented on DSE. In a Cox Proportional Hazards Model the strongest predictor of all-cause mortality was peak systolic SR (HR 4.46, 95%CI 2.45-8.11, p<0.01), exceeding both LVH (HR 1.82, 95%CI 0.88-3.77, p=0.11) and ischaemia (HR 0.73, 95%CI 0.34-1.54, p=0.4). Peak systolic SR remained the strongest predictor of all-cause mortality after dividing the population into those with ischaemia
(n=68, HR 8.96, 95%CI 2.78-28.91, p<0.01), without ischaemia (n=163, HR 3.1, 95%CI 1.49-6.46, p=0.03), with LVH (n=87, HR 2.84, 95%CI 1.36-5.96, p=0.06), and without LVH (n=144, HR 9.65, 95%CI 3.39-27.44, p<0.01). Kaplan-Meier
curves were constructed after grouping the data on the basis of the presence and/or absence of LVH and/or ischaemia (p<0.01 overall, figure).

Conclusion
Peak systolic strain rate during dobutamine stress echocardiography is a predictor of all-cause mortality independent of left ventricular hypertrophy and myocardial ischaemia.
Subjects 1102 Cardiovascular Medicine and Haematology
110201 Cardiology (incl. Cardiovascular Diseases)
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 22 Feb 2010, 15:56:48 EST by Jon Swabey on behalf of Faculty Of Health Sciences