Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging

Romano, Simone; Judd, Robert M.; Kim, Raymond J.; Kim, Han W.; Heitner, John F.; Shah, Dipan J.; Devereux, Richard B.; Salazar, Pablo; Trybula, Michael; Chia, Richard; Evans, Kaleigh L.; Farzaneh‐Far, Afshin

doi:10.1016/j.jcmg.2018.10.003

Cited by 33 publications

(18 citation statements)

References 40 publications

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“…Among an increasing number of studies using cardiovascular magnetic resonance, little comparative data exist with respect to the prognostic assessment of LV long‐axis function parameters 29–31 . A very recent paper revealed that both lateral MAPSE and feature tracking GLS independently contributed to risk prediction in hypertensive patients, which implies that these indices may supply complementary prognostic information 32 . We did not show any analogous relationship in our analysis, which might be explained by between‐modality and patient clinical profile differences.…”

Section: Discussioncontrasting

confidence: 59%

“…[29][30][31] A very recent paper revealed that both lateral MAPSE and feature tracking GLS independently contributed to risk prediction in hypertensive patients, which implies that these indices may supply complementary prognostic information. 32 We did not show any analogous relationship in our analysis, which might be explained by between-modality and patient clinical profile differences.…”

Section: Comparison Of LV Longitudinal Systolic Function Parameterscontrasting

confidence: 53%

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Comparison of left ventricular longitudinal systolic function parameters in the prediction of adverse outcome in heart failure with preserved ejection fraction

et al. 2021

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Aims Several different diagnostic parameters can be used to assess left ventricular (LV) longitudinal systolic function, but no studies comparing their predictive value have been conducted. We sought to compare the prognostic value of LV long-axis function parameters at rest and exercise using the population with heart failure with preserved ejection fraction (HFpEF). Methods and results Clinical and biochemical variables were collected at baseline in 201 patients with HFpEF. Echocardiography was performed at rest and immediately after exercise, with measurement of mitral annular plane systolic excursion, systolic tissue velocity (s′), global longitudinal strain (GLS), and global longitudinal strain rate (GLSR). Participants were followed for 48 (24-60) months for heart failure hospitalization and cardiovascular death. Seventy-four patients (36.8%) met the study endpoint. Cox regression analysis revealed that after adjustment for Meta-Analysis Global Group in Chronic Heart Failure risk score, brain natriuretic peptide (BNP), and peak VO 2 , heart failure hospitalization and cardiovascular death were significantly associated with GLS at rest [hazard ratio (HR) 0.91; 95% confidence interval (CI) 0.84-0.98; P = 0.016], GLS after exercise (HR 0.84; 95% CI 0.77-0.91; P < 0.001), and GLSR after exercise (HR 0.13; 95% CI 0.04-0.48; P = 0.002). The addition of each of the following: exercise GLS and GLSR and resting GLS to the base model including Meta-Analysis Global Group in Chronic Heart Failure, BNP, and peak VO 2 improved predictive power for the study endpoint [net reclassification improvement (NRI) = 49%, P < 0.001; NRI = 42%, P = 0.004; and NRI = 38%, P = 0.009, respectively]. Exercise GLS was the only longitudinal parameter significantly improving c-statistics of the base model (0.68 vs. 0.73; P = 0.047). Conclusions Echocardiographic parameters of LV longitudinal function are not equipotential in predicting adverse outcomes in HFpEF. LV deformation indices, especially assessed with exercise, show the highest predictive utility independent from and incremental to clinical data and BNP.

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Section: Discussioncontrasting

confidence: 59%

Section: Comparison Of LV Longitudinal Systolic Function Parameterscontrasting

confidence: 53%

Comparison of left ventricular longitudinal systolic function parameters in the prediction of adverse outcome in heart failure with preserved ejection fraction

et al. 2021

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“…Several prior studies have shown that ventricular longitudinal function assessed by echocardiography or CMR can predict adverse outcome in broad patient populations 12 , 14 , 15 , 16 as well as in specific non‐HFrEF patient groups—for example, idiopathic heart failure, 23 acute heart failure, 24 hypertension, 25 in individuals without current, or history of, heart disease, 26 and in the general population. 27 The novelty of the present study is that we demonstrate the strong prognostic values to predict mortality and morbidity for AVPD and GLS in patients with HFrEF and use a statistical method that takes into account reoccurring events.…”

Section: Discussionmentioning

confidence: 99%

Ventricular longitudinal function by cardiovascular magnetic resonance predicts cardiovascular morbidity in HFrEF patients

et al. 2022

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Aims Ventricular longitudinal function measured as basal‐apical atrioventricular plane displacement (AVPD) or global longitudinal strain (GLS) is a potent predictor of mortality and could potentially be a predictor of heart failure‐associated morbidity. We hypothesized that low AVPD and GLS are associated with the combined endpoint of cardiovascular mortality and heart failure‐associated morbidity. Methods and results Two hundred eighty‐seven patients (age 62 ± 12 years, 78% male) with heart failure with reduced (≤40%) ejection fraction (HFrEF) referred to a cardiovascular magnetic resonance exam were included. Ventricular longitudinal function, ventricular volume, and myocardial fibrosis or infarction were analysed from cine and late gadolinium enhancement images. National registries provided data on causes of cardiovascular hospitalizations and cardiovascular mortality for the combined endpoint. Time‐to‐event analysis capable of including reoccurring events was employed with a 5‐year follow‐up. HFrEF patients had EF 26.5 ± 8.0%, AVPD 7.8 ± 2.4 mm, and GLS −7.5 ± 3.0%. In contrast, ventricular longitudinal function was approximately twice as large in an age‐matched control group (AVPD 15.3 ± 1.6 mm; GLS −20.6 ± 2.0%; P < 0.001 for both). There were 578 events in total, and the majority were HF hospitalizations (n = 418). Other major events were revascularizations (n = 64), cardiovascular deaths (n = 40), and myocardial infarctions (n = 21). One hundred fifty‐five (54%) patients experienced at least one event (mean 2.0, range 0–64). Of these patients, 119 (71%) had three events or fewer, and the first three events comprised 51% of all events (295 events). Patients in the bottom AVPD or GLS tertile (<6.8 mm or >−6.1%) overall experienced more than 3 times as many events as the top tertile (>8.8 mm or <−8.4%; P < 0.001). Patients in this tertile also faced more cardiovascular deaths (P < 0.05), HF hospitalizations (P = 0.001), myocardial infarctions (only GLS: P = 0.032), and accumulated longer in‐hospital length‐of‐stay overall (AVPD 20.9 vs. 9.1 days; GLS 22.4 vs. 6.5 days; P = 0.001 for both), and from HF hospitalizations (AVPD 19.3 vs. 8.3 days; GLS 19.3 vs. 5.4 days; P = 0.001 for both). In multivariate analysis adjusted for significant covariates, AVPD and GLS remained independent predictors of events (hazard ratio 1.12 per‐mm‐decrease and 1.13 per‐%‐increase) alongside hyponatremia (<135 mmol/L), aetiology of HF, and LV end‐diastolic volume index. Conclusions Low ventricular longitudinal function is associated with an increase in number of events as well as longer in‐hospital stay from cardiovascular causes. In addition, AVPD and GLS have independent prognostic value for cardiovascular mortality and morbidity in HFrEF patients.

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“…In arterial hypertension, associated differences in left ventricular afterload between chronic late and early LV afterload increase present with development active left ventricular relaxation abnormality and early heart failure [1,2,5,9,11,12,15,16,24,27,28]. In hypertension, chronic late left ventricular afterload increase is related to prolonged active left ventricular relaxation with abnormality and development of systolic left ventricular dysfunction, reduced left atrial function and remodeling, increased left atrial size and ventricular-atrial decoupling [1, 2, 4, 9, 11-13, 15, 21, 24].…”

Section: Introductionmentioning

confidence: 99%

Prolonged Asynchronous Left Ventricular Isovolumic Relaxation Constant in Ascending Compared to Descending Thoracic Aortic Stenosis for Chronic Early Left Ventricular Afterload and Late Left Ventricular Afterload Increase

Popevska

Rademakers

2022

Prilozi

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Background: In arterial hypertension, left ventricular relaxation is affected early on in relation to a chronic difference in peak left ventricular afterload with early development of HF. Objective: in ascending compares to descending thoracic aortic stenosis, resulting in chronic late and early LV afterload increase, to assess the left ventricular isovolumic relaxation pressure decay constant through regression analysis, a parameter of left ventricular relaxation on the 4th and 8th week period from invasive left ventricular pressure measurements. Methods: fourteen pigs underwent posterolateral thoracotomy for ascending aortic stenosis, resulting in chronic early left ventricular afterload increase (EL = 6], or descending thoracic aortic stenosis creating chronic late systolic left ventricular load (LL = 8]. Exponential regression with nonzero asymptote for τ assessment, with linear and nonlinear regression were performed on isovolumic relaxation pressure decay from the left ventricular invasive pressure measurements on 4th and 8th week. Two-way repeated measurement ANOVA, post-hoc Tukey test and linear regression were performed for statistical analysis. Results presented are mean ± SEM or median (quartiles], with significance is at p < 0.05. Results: The ascending aortic stenosis associated with prolonged biexponential asynchronous τ, compared to the descending thoracic aorta stenosis, resulted in data that were different at the 8th week in presence of respirations (interaction p < 0.05]. Monoexponential and linear τ were not different in either respiration being preserved or suspended transitionally and in preload reduction. Preload sensitive response of τ was found in ascending compared to descending thoracic aortic banding that reduced in EL and in LL it increased with load reduction (p < 0.05]. These results indicated that τ is not different in and between LV afterloading conditions in a chronic setting, although it indicates that myocardial ischemia is present and that it is greater in ascending aortic banding, compared to descending thoracic aorta banding at the 8th week. Conclusion: In different sequence of the left ventricular afterload, ventricular relaxation is affected early on, having in EL compared to LL prolonged biexponential asynchronous left ventricular relaxation constant, thus indicating the development left ventricular myocardial ischemia and different elastic recoil in an invasive left ventricular hemodynamic assessment.

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Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging

Cited by 33 publications

References 40 publications

Comparison of left ventricular longitudinal systolic function parameters in the prediction of adverse outcome in heart failure with preserved ejection fraction

Comparison of left ventricular longitudinal systolic function parameters in the prediction of adverse outcome in heart failure with preserved ejection fraction

Ventricular longitudinal function by cardiovascular magnetic resonance predicts cardiovascular morbidity in HFrEF patients

Prolonged Asynchronous Left Ventricular Isovolumic Relaxation Constant in Ascending Compared to Descending Thoracic Aortic Stenosis for Chronic Early Left Ventricular Afterload and Late Left Ventricular Afterload Increase

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