Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling

Research output: Contribution to journalArticle

Authors

External Institution(s)

  • National Institutes of Health
  • Boston University
  • University of Massachusetts Medical School
  • Cardiovascular Engineering, Inc.
  • Harvard University
  • Veterans Administration Hospital

Details

Original languageEnglish (US)
Pages (from-to)72-81.e6
JournalJournal of the American Society of Echocardiography
Volume33
Issue number1
StatusPublished - Jan 2020
Peer-reviewedYes

Abstract

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.

    Research areas

  • Echocardiography, Epidemiology, Mortality, Outcome, Risk stratification

Citation formats

APA

von Jeinsen, B., Short, M. I., Larson, M. G., Xanthakis, V., McManus, D. D., Benjamin, E. J., ... Vasan, R. S. (2020). Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling. Journal of the American Society of Echocardiography, 33(1), 72-81.e6. https://doi.org/10.1016/j.echo.2019.08.001

Harvard

von Jeinsen, B, Short, MI, Larson, MG, Xanthakis, V, McManus, DD, Benjamin, EJ, Mitchell, GF, Aragam, J, Cheng, S & Vasan, RS 2020, 'Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling', Journal of the American Society of Echocardiography, vol. 33, no. 1, pp. 72-81.e6. https://doi.org/10.1016/j.echo.2019.08.001