BACKGROUND In recent decades, novel echocardiographic measures have constantly emerged. It is still unclear which echocardiographic measures have the most significant prognostic value in the general population. Accordingly, the aim of this study was to compare the prognostic value of a large panel of echocardiographic measures to identify the most promising measures. METHODS A total of 1,497 Framingham study participants (mean age, 65 years; 55.4% women) who underwent echocardiographic measurements of left ventricular ejection fraction, left ventricular mass index, global longitudinal strain, global circumferential strain, mitral annular plane systolic excursion, mitral E/e' ratio, maximum and minimum left atrial (LA) volume index, LA emptying fraction, and left ventricular longitudinal synchrony were evaluated. These measures were related to the incidence of two composite outcomes: cardiovascular disease (CVD) or death and atrial fibrillation (AF) or congestive heart failure (CHF). RESULTS On follow-up (mean, 8.3 years), there were 241 CVD events or deaths and 139 AF or CHF events. In multivariate-adjusted Cox models, higher LA emptying fraction was associated with a lower risk (hazard ratios per SD, 0.80 and 0.70 for CVD or death and AF or CHF, respectively; P ≤ .001 for both) while higher minimum LA volume index (hazard ratios per SD, 1.32 and 1.70 for CVD or death and AF or CHF, respectively; P ≤ .001 for both) and maximum LA volume index (hazard ratios per SD, 1.26 and 1.54 for CVD or death and AF or CHF, respectively; P ≤ .002 for both) were associated with a higher risk for both composite outcomes. CONCLUSIONS In this community-based sample, LA volumes and function were the best echocardiographic predictors of clinical outcomes. Therefore, these values should be considered for inclusion in standard echocardiographic assessments for the purpose of risk stratification.

中文翻译：

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心脏重塑的超声心动图测量的预后意义。

背景技术近几十年来，不断涌现出新颖的超声心动图测量方法。目前尚不清楚哪些超声心动图测量在普通人群中具有最显着的预后价值。因此，本研究的目的是比较一大组超声心动图测量的预后价值，以确定最有希望的测量。方法 共有 1,497 名弗雷明汉研究参与者（平均年龄 65 岁；55.4% 女性）接受超声心动图测量左心室射血分数、左心室质量指数、整体纵向应变、整体环向应变、二尖瓣环平面收缩期偏移、二尖瓣 E /e' 比率、最大和最小左心房 (LA) 容积指数、LA 排空分数和左心室纵向同步性进行了评估。这些测量与两种复合结局的发生率有关：心血管疾病 (CVD) 或死亡和心房颤动 (AF) 或充血性心力衰竭 (CHF)。结果 随访（平均 8.3 年），有 241 例 CVD 事件或死亡和 139 例 AF 或 CHF 事件。在多变量调整的 Cox 模型中，较高的 LA 排空分数与较低的风险相关（每个 SD 的风险比分别为 0.80 和 0.70，CVD 或死亡和 AF 或 CHF；两者的 P ≤ .001），同时较高的最小 LA 体积指数（CVD 或死亡和 AF 或 CHF 的风险比分别为 1.32 和 1.70；两者的 P ≤ .001）和最大 LA 体积指数（CVD 或死亡和 AF 或 CHF 的风险比每 SD 分别为 1.26 和 1.54，分别；两者的 P ≤ .002）与两种复合结局的较高风险相关。结论 在这个基于社区的样本中，LA 体积和功能是临床结果的最佳超声心动图预测指标。因此，出于风险分层的目的，应考虑将这些值纳入标准超声心动图评估中。