Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction

Inge Noringriis; Daniel Modin; Sune H Pedersen; Jan S Jensen; Tor Biering-Sørensen

doi:10.1007/s10554-018-1443-9

Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction

Inge Noringriis, Daniel Modin, Sune H Pedersen, Jan S Jensen, Tor Biering-Sørensen

1 Citationer (Scopus)

Abstract

The aim of this study is to assess the prognostic value of mechanical dyssynchrony defined as the standard deviation of the time to peak longitudinal strain (SD T2P LS) in predicting the development of heart failure (HF) after an ST-segment elevation myocardial infarction (STEMI). Three hundred and seventy-three patients were admitted with STEMI and treated with primary percutaneous coronary intervention. Left ventricular (LV) mechanical dyssynchrony was examined through speckle tracking echocardiography and defined as SD T2P LS. The association with the outcome of HF hospitalization was assessed using Cox proportional hazard models. During a median follow-up of 5.12 years, 144 patients (38.6%) were admitted due to HF. Worse dyssynchrony was associated with the outcome in unadjusted and multivariable analysis (multivariable hazard ratio 1.05, 95% confidence interval 1.00-1.10, p-value 0.039, per 10 ms increase), but not after further adjustment for LV ejection fraction (LVEF), E/e' and global longitudinal strain (GLS) (hazard ratio 1.01, 95% confidence interval 1.00-1.07, p-value 0.71, per 10 ms increase), nor in a model only adjusting for GLS (hazard ratio 1.01, 95% confidence interval 1.00-1.06, p-value 0.61, per 10 ms increase). These findings were reproduced in a competing risk analysis treating all-cause mortality as a competing risk. LV mechanical dyssynchrony, as assessed by SD T2P LS is not an independent predictor of post-STEMI HF development and mechanical dyssynchrony does not provide independent prognostic information regarding HF when GLS is known.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiovascular Imaging
Vol/bind	35
Udgave nummer	1
Sider (fra-til)	87-97
ISSN	1569-5794
DOI	https://doi.org/10.1007/s10554-018-1443-9
Status	Udgivet - 15 jan. 2019

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10.1007/s10554-018-1443-9

Citationsformater

Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction. / Noringriis, Inge; Modin, Daniel; Pedersen, Sune H et al.

I: International Journal of Cardiovascular Imaging, Bind 35, Nr. 1, 15.01.2019, s. 87-97.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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title = "Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction",

abstract = "The aim of this study is to assess the prognostic value of mechanical dyssynchrony defined as the standard deviation of the time to peak longitudinal strain (SD T2P LS) in predicting the development of heart failure (HF) after an ST-segment elevation myocardial infarction (STEMI). Three hundred and seventy-three patients were admitted with STEMI and treated with primary percutaneous coronary intervention. Left ventricular (LV) mechanical dyssynchrony was examined through speckle tracking echocardiography and defined as SD T2P LS. The association with the outcome of HF hospitalization was assessed using Cox proportional hazard models. During a median follow-up of 5.12 years, 144 patients (38.6%) were admitted due to HF. Worse dyssynchrony was associated with the outcome in unadjusted and multivariable analysis (multivariable hazard ratio 1.05, 95% confidence interval 1.00-1.10, p-value 0.039, per 10 ms increase), but not after further adjustment for LV ejection fraction (LVEF), E/e' and global longitudinal strain (GLS) (hazard ratio 1.01, 95% confidence interval 1.00-1.07, p-value 0.71, per 10 ms increase), nor in a model only adjusting for GLS (hazard ratio 1.01, 95% confidence interval 1.00-1.06, p-value 0.61, per 10 ms increase). These findings were reproduced in a competing risk analysis treating all-cause mortality as a competing risk. LV mechanical dyssynchrony, as assessed by SD T2P LS is not an independent predictor of post-STEMI HF development and mechanical dyssynchrony does not provide independent prognostic information regarding HF when GLS is known.",

keywords = "Aged, Echocardiography, Female, Heart Failure/diagnostic imaging, Humans, Male, Middle Aged, Patient Readmission, Percutaneous Coronary Intervention/adverse effects, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction/diagnosis, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left/diagnostic imaging, Ventricular Function, Left",

author = "Inge Noringriis and Daniel Modin and Pedersen, {Sune H} and Jensen, {Jan S} and Tor Biering-S{\o}rensen",

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doi = "10.1007/s10554-018-1443-9",

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T1 - Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction

AU - Noringriis, Inge

AU - Modin, Daniel

AU - Pedersen, Sune H

AU - Jensen, Jan S

AU - Biering-Sørensen, Tor

PY - 2019/1/15

Y1 - 2019/1/15

N2 - The aim of this study is to assess the prognostic value of mechanical dyssynchrony defined as the standard deviation of the time to peak longitudinal strain (SD T2P LS) in predicting the development of heart failure (HF) after an ST-segment elevation myocardial infarction (STEMI). Three hundred and seventy-three patients were admitted with STEMI and treated with primary percutaneous coronary intervention. Left ventricular (LV) mechanical dyssynchrony was examined through speckle tracking echocardiography and defined as SD T2P LS. The association with the outcome of HF hospitalization was assessed using Cox proportional hazard models. During a median follow-up of 5.12 years, 144 patients (38.6%) were admitted due to HF. Worse dyssynchrony was associated with the outcome in unadjusted and multivariable analysis (multivariable hazard ratio 1.05, 95% confidence interval 1.00-1.10, p-value 0.039, per 10 ms increase), but not after further adjustment for LV ejection fraction (LVEF), E/e' and global longitudinal strain (GLS) (hazard ratio 1.01, 95% confidence interval 1.00-1.07, p-value 0.71, per 10 ms increase), nor in a model only adjusting for GLS (hazard ratio 1.01, 95% confidence interval 1.00-1.06, p-value 0.61, per 10 ms increase). These findings were reproduced in a competing risk analysis treating all-cause mortality as a competing risk. LV mechanical dyssynchrony, as assessed by SD T2P LS is not an independent predictor of post-STEMI HF development and mechanical dyssynchrony does not provide independent prognostic information regarding HF when GLS is known.

AB - The aim of this study is to assess the prognostic value of mechanical dyssynchrony defined as the standard deviation of the time to peak longitudinal strain (SD T2P LS) in predicting the development of heart failure (HF) after an ST-segment elevation myocardial infarction (STEMI). Three hundred and seventy-three patients were admitted with STEMI and treated with primary percutaneous coronary intervention. Left ventricular (LV) mechanical dyssynchrony was examined through speckle tracking echocardiography and defined as SD T2P LS. The association with the outcome of HF hospitalization was assessed using Cox proportional hazard models. During a median follow-up of 5.12 years, 144 patients (38.6%) were admitted due to HF. Worse dyssynchrony was associated with the outcome in unadjusted and multivariable analysis (multivariable hazard ratio 1.05, 95% confidence interval 1.00-1.10, p-value 0.039, per 10 ms increase), but not after further adjustment for LV ejection fraction (LVEF), E/e' and global longitudinal strain (GLS) (hazard ratio 1.01, 95% confidence interval 1.00-1.07, p-value 0.71, per 10 ms increase), nor in a model only adjusting for GLS (hazard ratio 1.01, 95% confidence interval 1.00-1.06, p-value 0.61, per 10 ms increase). These findings were reproduced in a competing risk analysis treating all-cause mortality as a competing risk. LV mechanical dyssynchrony, as assessed by SD T2P LS is not an independent predictor of post-STEMI HF development and mechanical dyssynchrony does not provide independent prognostic information regarding HF when GLS is known.

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KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Readmission

KW - Percutaneous Coronary Intervention/adverse effects

KW - Risk Assessment

KW - Risk Factors

KW - ST Elevation Myocardial Infarction/diagnosis

KW - Time Factors

KW - Treatment Outcome

KW - Ventricular Dysfunction, Left/diagnostic imaging

KW - Ventricular Function, Left

U2 - 10.1007/s10554-018-1443-9

DO - 10.1007/s10554-018-1443-9

M3 - Journal article

C2 - 30143920

SN - 1569-5794

VL - 35

SP - 87

EP - 97

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

IS - 1

ER -

Prognostic importance of mechanical dyssynchrony in predicting heart failure development after ST-segment elevation myocardial infarction

Abstract

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