Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

Mads Ersbøll; Nana Valeur; Ulrik Madvig Mogensen; Mads Jønsson Andersen; Jacob Eifer Møller; Eric J Velazquez; Christian Hassager; Peter Søgaard; Lars Køber

doi:10.1016/j.jacc.2013.02.061

Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

Mads Ersbøll, Nana Valeur, Ulrik Madvig Mogensen, Mads Jønsson Andersen, Jacob Eifer Møller, Eric J Velazquez, Christian Hassager, Peter Søgaard, Lars Køber

Department of Clinical Medicine

234 Citations (Scopus)

Abstract

Objectives This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%. Background LVEF is a key determinant in decision making after acute MI, yet it is relatively indiscriminant within the normal range. Novel echocardiographic deformation parameters may be of particular clinical relevance in patients with relatively preserved LVEFs. Methods Patients with MIs and LVEFs >40% within 48 h of admission for coronary angiography were prospectively included. All patients underwent echocardiography with semiautomated measurement of GLS. The primary composite endpoint (all-cause mortality and hospitalization for heart failure) was analyzed using Cox regression analyses. The secondary endpoints were cardiac death and heart failure hospitalization. Results A total of 849 patients (mean age 61.9 ± 12.0 years, 73% men) were included, and 57 (6.7%) reached the primary endpoint (median follow-up 30 months). Significant prognostic value was found for GLS (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.10 to 1.32; p < 0.001). GLS > -14% was associated with a 3-fold increase in risk for the combined endpoint (HR: 3.21; 95% CI: 1.82 to 5.67; p < 0.001). After adjustment for other variables, GLS remained independently related to the combined endpoint (HR: 1.14; 95% CI: 1.04 to 1.26; p = 0.007). For the secondary endpoints, GLS > -14% was significantly associated with cardiovascular death (HR: 12.7; 95% CI: 3.0 to 54.6; p < 0.001) and heart failure hospitalization (HR: 5.31; 95% CI: 1.50 to 18.82; p < 0.001). Conclusions Assessment of GLS using a semiautomated algorithm provides important prognostic information in patients with LVEFs >40% above and beyond traditional indexes of high-risk MI.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	61
Issue number	23
Pages (from-to)	2365-2373
Number of pages	9
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2013.02.061
Publication status	Published - 11 Jun 2013

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Ersbøll, M., Valeur, N., Mogensen, U. M., Andersen, M. J., Møller, J. E., Velazquez, E. J., Hassager, C., Søgaard, P., & Køber, L. (2013). Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. Journal of the American College of Cardiology, 61(23), 2365-2373. https://doi.org/10.1016/j.jacc.2013.02.061

Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. / Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig et al.

In: Journal of the American College of Cardiology, Vol. 61, No. 23, 11.06.2013, p. 2365-2373.

Research output: Contribution to journal › Journal article › Research › peer-review

Ersbøll, M, Valeur, N, Mogensen, UM, Andersen, MJ, Møller, JE, Velazquez, EJ, Hassager, C, Søgaard, P & Køber, L 2013, 'Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction', Journal of the American College of Cardiology, vol. 61, no. 23, pp. 2365-2373. https://doi.org/10.1016/j.jacc.2013.02.061

Ersbøll M, Valeur N, Mogensen UM, Andersen MJ, Møller JE, Velazquez EJ et al. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. Journal of the American College of Cardiology. 2013 Jun 11;61(23):2365-2373. doi: 10.1016/j.jacc.2013.02.061

@article{0780d0f2708145ad8e0580d76c063d61,

title = "Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction",

abstract = "Objectives This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%. Background LVEF is a key determinant in decision making after acute MI, yet it is relatively indiscriminant within the normal range. Novel echocardiographic deformation parameters may be of particular clinical relevance in patients with relatively preserved LVEFs. Methods Patients with MIs and LVEFs >40% within 48 h of admission for coronary angiography were prospectively included. All patients underwent echocardiography with semiautomated measurement of GLS. The primary composite endpoint (all-cause mortality and hospitalization for heart failure) was analyzed using Cox regression analyses. The secondary endpoints were cardiac death and heart failure hospitalization. Results A total of 849 patients (mean age 61.9 ± 12.0 years, 73% men) were included, and 57 (6.7%) reached the primary endpoint (median follow-up 30 months). Significant prognostic value was found for GLS (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.10 to 1.32; p < 0.001). GLS > -14% was associated with a 3-fold increase in risk for the combined endpoint (HR: 3.21; 95% CI: 1.82 to 5.67; p < 0.001). After adjustment for other variables, GLS remained independently related to the combined endpoint (HR: 1.14; 95% CI: 1.04 to 1.26; p = 0.007). For the secondary endpoints, GLS > -14% was significantly associated with cardiovascular death (HR: 12.7; 95% CI: 3.0 to 54.6; p < 0.001) and heart failure hospitalization (HR: 5.31; 95% CI: 1.50 to 18.82; p < 0.001). Conclusions Assessment of GLS using a semiautomated algorithm provides important prognostic information in patients with LVEFs >40% above and beyond traditional indexes of high-risk MI.",

author = "Mads Ersb{\o}ll and Nana Valeur and Mogensen, {Ulrik Madvig} and Andersen, {Mads J{\o}nsson} and M{\o}ller, {Jacob Eifer} and Velazquez, {Eric J} and Christian Hassager and Peter S{\o}gaard and Lars K{\o}ber",

year = "2013",

month = jun,

day = "11",

doi = "10.1016/j.jacc.2013.02.061",

language = "English",

volume = "61",

pages = "2365--2373",

journal = "Journal of the American College of Cardiology",

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TY - JOUR

T1 - Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

AU - Ersbøll, Mads

AU - Valeur, Nana

AU - Mogensen, Ulrik Madvig

AU - Andersen, Mads Jønsson

AU - Møller, Jacob Eifer

AU - Velazquez, Eric J

AU - Hassager, Christian

AU - Søgaard, Peter

AU - Køber, Lars

PY - 2013/6/11

Y1 - 2013/6/11

N2 - Objectives This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%. Background LVEF is a key determinant in decision making after acute MI, yet it is relatively indiscriminant within the normal range. Novel echocardiographic deformation parameters may be of particular clinical relevance in patients with relatively preserved LVEFs. Methods Patients with MIs and LVEFs >40% within 48 h of admission for coronary angiography were prospectively included. All patients underwent echocardiography with semiautomated measurement of GLS. The primary composite endpoint (all-cause mortality and hospitalization for heart failure) was analyzed using Cox regression analyses. The secondary endpoints were cardiac death and heart failure hospitalization. Results A total of 849 patients (mean age 61.9 ± 12.0 years, 73% men) were included, and 57 (6.7%) reached the primary endpoint (median follow-up 30 months). Significant prognostic value was found for GLS (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.10 to 1.32; p < 0.001). GLS > -14% was associated with a 3-fold increase in risk for the combined endpoint (HR: 3.21; 95% CI: 1.82 to 5.67; p < 0.001). After adjustment for other variables, GLS remained independently related to the combined endpoint (HR: 1.14; 95% CI: 1.04 to 1.26; p = 0.007). For the secondary endpoints, GLS > -14% was significantly associated with cardiovascular death (HR: 12.7; 95% CI: 3.0 to 54.6; p < 0.001) and heart failure hospitalization (HR: 5.31; 95% CI: 1.50 to 18.82; p < 0.001). Conclusions Assessment of GLS using a semiautomated algorithm provides important prognostic information in patients with LVEFs >40% above and beyond traditional indexes of high-risk MI.

AB - Objectives This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%. Background LVEF is a key determinant in decision making after acute MI, yet it is relatively indiscriminant within the normal range. Novel echocardiographic deformation parameters may be of particular clinical relevance in patients with relatively preserved LVEFs. Methods Patients with MIs and LVEFs >40% within 48 h of admission for coronary angiography were prospectively included. All patients underwent echocardiography with semiautomated measurement of GLS. The primary composite endpoint (all-cause mortality and hospitalization for heart failure) was analyzed using Cox regression analyses. The secondary endpoints were cardiac death and heart failure hospitalization. Results A total of 849 patients (mean age 61.9 ± 12.0 years, 73% men) were included, and 57 (6.7%) reached the primary endpoint (median follow-up 30 months). Significant prognostic value was found for GLS (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.10 to 1.32; p < 0.001). GLS > -14% was associated with a 3-fold increase in risk for the combined endpoint (HR: 3.21; 95% CI: 1.82 to 5.67; p < 0.001). After adjustment for other variables, GLS remained independently related to the combined endpoint (HR: 1.14; 95% CI: 1.04 to 1.26; p = 0.007). For the secondary endpoints, GLS > -14% was significantly associated with cardiovascular death (HR: 12.7; 95% CI: 3.0 to 54.6; p < 0.001) and heart failure hospitalization (HR: 5.31; 95% CI: 1.50 to 18.82; p < 0.001). Conclusions Assessment of GLS using a semiautomated algorithm provides important prognostic information in patients with LVEFs >40% above and beyond traditional indexes of high-risk MI.

U2 - 10.1016/j.jacc.2013.02.061

DO - 10.1016/j.jacc.2013.02.061

M3 - Journal article

C2 - 23563128

SN - 0735-1097

VL - 61

SP - 2365

EP - 2373

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 23

ER -