Abnormal myocardial deformation is associated with mortality independent of hypertrophy in the absence of ischemia

Haluska, Brian, Hare, James, Ingul, Charlotte Bjork, Marwick, Thomas H. and Stanton, Tony (2008). Abnormal myocardial deformation is associated with mortality independent of hypertrophy in the absence of ischemia. In: Circulation. Abstracts from Scientific Sessions 2008. Scientific Sessions 2008, New Orleans, LA, U.S.A., (s850-s850). 8-12 November 2008.


Author Haluska, Brian
Hare, James
Ingul, Charlotte Bjork
Marwick, Thomas H.
Stanton, Tony
Title of paper Abnormal myocardial deformation is associated with mortality independent of hypertrophy in the absence of ischemia
Conference name Scientific Sessions 2008
Conference location New Orleans, LA, U.S.A.
Conference dates 8-12 November 2008
Proceedings title Circulation. Abstracts from Scientific Sessions 2008   Check publisher's open access policy
Place of Publication Baltimore, MD., U.S.A.
Publisher Lippincott, Williams & Wilkins for the American Heart Association
Publication Year 2008
ISSN 0009-7322
1524-4539
Volume 118
Issue 18, Supp. 2
Start page s850
End page s850
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 with 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 DSE. Mean Bethesda scores indicated a low ten-year risk of coronary disease (men 3.2±2.1%, women 5.3±2.6%). Relative wall thickness (RWT) and LVMI (indexed to height2.7) were calculated according to ASE guidelines. Customized software was used to measure peak systolic SR in 18 segments and 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/m2.7 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 (p<0.01 overall).

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 ischemia may be consistent with an effect of interstitial changes on mortality. © 2008 American Heart Association
Subjects 1102 Cardiovascular Medicine and Haematology
Keyword Echocardiography
Myocardial deformation
Hypertrophy
Ischemia
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Published in section: Diagnostic and prognostic utility of echocardiography in patients with chest pain. Abstract #4235

 
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Created: Fri, 26 Feb 2010, 16:19:46 EST by Gerald Martin on behalf of Mater Clinical School