Association between myocardial work indices and cardiovascular events according to hypertension in the general population
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Association between myocardial work indices and cardiovascular events according to hypertension in the general population. / Olsen, Flemming Javier; Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Højbjerg; Johansen, Niklas Dyrby; Jensen, Gorm Boje; Schnohr, Peter; Marott, Jacob Louis; Søgaard, Peter; Gislason, Gunnar; Svendsen, Jesper Hastrup; Møgelvang, Rasmus; Aalen, John Moene; Smiseth, Otto Armin; Remme, Espen Wattenberg; Biering-Sørensen, Tor.
In: European heart journal. Cardiovascular Imaging, Vol. 25, No. 3, 2024, p. 413-424.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Association between myocardial work indices and cardiovascular events according to hypertension in the general population
AU - Olsen, Flemming Javier
AU - Skaarup, Kristoffer Grundtvig
AU - Lassen, Mats Christian Højbjerg
AU - Johansen, Niklas Dyrby
AU - Jensen, Gorm Boje
AU - Schnohr, Peter
AU - Marott, Jacob Louis
AU - Søgaard, Peter
AU - Gislason, Gunnar
AU - Svendsen, Jesper Hastrup
AU - Møgelvang, Rasmus
AU - Aalen, John Moene
AU - Smiseth, Otto Armin
AU - Remme, Espen Wattenberg
AU - Biering-Sørensen, Tor
N1 - © 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.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Male
KW - Humans
KW - Middle Aged
KW - Female
KW - Cohort Studies
KW - Prospective Studies
KW - Myocardium
KW - Hypertension/epidemiology
KW - Heart Failure/diagnostic imaging
KW - Atherosclerosis
KW - Ventricular Function, Left
KW - Stroke Volume
U2 - 10.1093/ehjci/jead292
DO - 10.1093/ehjci/jead292
M3 - Journal article
C2 - 37930752
VL - 25
SP - 413
EP - 424
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 3
ER -
ID: 384024211