Subclinical LV dysfunction influences outcome: Association of abnormal myocardial deformation and mortality independent of hypertrophy and in the absence of ischaemia

Stanton, T., Bjork Ingul, C., Hare, J. L., Leano, R. and Marwick, T. H. (2008). Subclinical LV dysfunction influences outcome: Association of abnormal myocardial deformation and mortality independent of hypertrophy and in the absence of ischaemia. In: European Journal of Echocardiography. The Twelfth Annual Meeting of the European Association of Echocardiography, a registered branch of the ESC. Euroecho 2008: Twelfth Annual Meeting of the European Association of Echocardiography, 10-13 December 2008, (S157-S157). Lyon, France. doi:10.1093/ejechocard/jen287


Author Stanton, T.
Bjork Ingul, C.
Hare, J. L.
Leano, R.
Marwick, T. H.
Title of paper Subclinical LV dysfunction influences outcome: Association of abnormal myocardial deformation and mortality independent of hypertrophy and in the absence of ischaemia
Conference name Euroecho 2008: Twelfth Annual Meeting of the European Association of Echocardiography
Conference location 10-13 December 2008
Conference dates Lyon, France
Proceedings title European Journal of Echocardiography. The Twelfth Annual Meeting of the European Association of Echocardiography, a registered branch of the ESC   Check publisher's open access policy
Place of Publication London, U.K.
Publisher Oxford University Press
Publication Year 2008
Sub-type Poster
DOI 10.1093/ejechocard/jen287
ISSN 1525-2167; 532-2114
Volume 9
Issue Supp. 1
Start page S157
End page S157
Total pages 1
Language eng
Formatted Abstract/Summary
Purpose
Myocardial deformation has been shown to identify subclinical abnormalities in apparently normal hearts. We investigated the association of these markers on mortality after excluding ischemia in individuals undergoing dobutamine stress echocardiography(DSE).

Methods
We studied 163 consecutive patients with normal resting LV function and no ischemia at dobutamine stress echocardiography. Relative wall thickness (RWT) and
LVMI (indexed to height 2.7) were calculated according to the American Society of Echocardiography (ASE) guidelines. Customized software was used to measure peak systolic SR in 18 myocardial segments and the mean global SR was calculated. Individuals were followed for all-cause mortality for a mean of 5.4+1.4 years.

Results
Mean RWT 0.46+0.11 (normal < 0.42) and mean LVMI was 46.8+13.0g/m 2.7 (normal<51g/m 2.7). RWT and LVMI were assessed in the closest approximation to 1 standard deviation (per change of 0.1 for RWT and 10g/m 2.7 for LVMI). In a Cox Proportional Hazards Model the strongest predictor of all-cause mortality was peak systolic SR (HR 3.72, 95%CI 1.8-7.65, p<0.01). RWT (HR 1.4, 95%CI 1.0-1.96, p<0.05) was a stronger predictor of all-cause mortality than LVMI (HR 1.2, 95%CI 0.86-1.96,
p=NS). Kaplan Meier curves were constructed by grouping the data into tertiles according to peak systolic SR.

Conclusion
Peak systolic strain rate is a significant independent predictor of all-cause mortality, superior to LVMI and RWT. This link between myocardial deformation and outcome in the absence of myocardial ischaemia may be consistent with an effect of interstitial changes on mortality.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008.
Subjects 1102 Cardiovascular Medicine and Haematology
110201 Cardiology (incl. Cardiovascular Diseases)
Keyword Myocardial deformation
Ischemia
Dobutamine stress echocardiography(DSE)
Kaplan Meier curves
Peak systolic strain rate
Mortality
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Published as "Poster 1168" under "Saturday, 13 December 2008 : Poster session V : Stress Echo".

 
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Created: Tue, 23 Feb 2010, 10:20:59 EST by Jon Swabey on behalf of Faculty Of Health Sciences