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The cardiac isovolumetric contraction time is an independent predictor of incident heart failure in the general population.
International Journal of Cardiology ( IF 3.5 ) Pub Date : 2020-03-19 , DOI: 10.1016/j.ijcard.2020.03.046
Alia Saed Alhakak 1 , Rasmus Møgelvang 2 , Peter Schnohr 3 , Daniel Modin 1 , Philip Brainin 1 , Gunnar Gislason 4 , Tor Biering-Sørensen 5
Affiliation  

Background

Color Tissue Doppler imaging (TDI) M-mode through the mitral leaflet is a novel method to obtain the cardiac time intervals including the isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and ejection time (ET). The myocardial performance index (MPI) is defined as [(IVCT+IVRT)/ET]. Our aim was to investigate if the cardiac time intervals can be used to predict heart failure (HF) in the general population.

Methods and results

A total of 1915 participants (mean age 58 ± 16 years, 42% male) from the general population (The Copenhagen City Heart Study) underwent a health examination including TDI-echocardiography. The primary endpoint was incident HF. Participants with a history of HF were excluded (n = 23). During a median follow-up time of 16 years, 172 (9%) participants were diagnosed with incident HF. The risk of HF increased with 24% per 10 ms increase in IVCT (per 10 ms increase: HR 1.24; 95%CI (1.14–1.36), p < 0.001). The association remained significant after adjusting for age, sex, hypertension, diabetes, previous ischemic heart disease, diastolic blood pressure, heart rate, body mass index, eGFR, proBNP, LVEF <50%, s′, LAVI, and E/e′ (per 10 ms increase: HR 1.13; 95% CI (1.00–1.27), p = 0.045).

A significant association was found between MPI and HF both in unadjusted and adjusted models (per 0.1 increase: HR 6.93; 95% CI (1.63–29.31), p = 0.009). No associations between the IVRT or ET and HF remained significant after multivariable adjustment.

Conclusion

In the general population the IVCT provides novel and independent prognostic information on the long-term risk of incident HF.



中文翻译:

心脏等容收缩时间是一般人群中事件性心力衰竭的独立预测因子。

背景

通过二尖瓣小叶的彩色组织多普勒成像(TDI)M模式是获得包括等容收缩时间(IVCT),等容舒张时间(IVRT)和射血时间(ET)在内的心脏时间间​​隔的一种新方法。心肌功能指数(MPI)定义为[(IVCT + IVRT)/ ET]。我们的目的是调查心脏时间间​​隔是否可用于预测一般人群的心力衰竭(HF)。

方法与结果

总人口(哥本哈根市心脏研究)共有1915名参与者(平均年龄58±16岁,男性占42%)接受了包括TDI超声心动图在内的健康检查。主要终点是HF。有心衰史的参与者被排除(n  = 23)。在16年的平均随访时间中,有172名(9%)参与者被诊断出患有HF。HF的风险增加,IVCT每10 ms增加24%(每10 ms增加:HR 1.24; 95%CI(1.14–1.36),p  <0.001)。在调整了年龄,性别,高血压,糖尿病,先前的缺血性心脏病,舒张压,心率,体重指数,eGFR,proBNP,LVEF <50%,s',LAVI和E / e'之后,该关联仍然显着(每10毫秒增加:HR 1.13; 95%CI(1.00–1.27),p = 0.045)。

在未经调整和经过调整的模型中,MPI和HF之间均存在显着相关性(每增加0.1:HR 6.93; 95%CI(1.63-29.31),p  = 0.009)。多变量调整后,IVRT或ET与HF之间无明显关联。

结论

在一般人群中,IVCT提供了有关HF长期风险的新颖且独立的预后信息。

更新日期:2020-03-19
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