Sistema de Salut de Catalunya
Institut Català de la Salut
[Cesareo M] Hypertension Unit, Division of Internal Medicine, University Hospital Città della Salute e della Scienza of Turin, Turin, Italy. Department of Medical Sciences, University of Turin, Turin, Italy. [Ródenas-Alesina E, Rodriguez-Palomares JF] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Centro de Investigación Biomédica en Red-Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain. [Guala A] Centro de Investigación Biomédica en Red-Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Lozano-Torres J] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Casas G] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Centro de Investigación Biomédica en Red-Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain. [Vallelonga F] Department of Medical Sciences, University of Turin, Turin, Italy. Division of Internal Medicine, Candiolo Cancer Institute-Fondazione del Piemonte per l’Oncologia (FPO)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Turin, Italy. [Ferreira-González I] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-07-22T06:30:20Z
2024-07-22T06:30:20Z
2024-06-30
Dilated cardiomyopathy; Echocardiography; Hemodynamic forces
Miocardiopatía dilatada; Ecocardiografía; Fuerzas hemodinámicas
Miocardiopatia dilatada; Ecocardiografia; Forces hemodinàmiques
Introduction: Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by a reduced left ventricular (LV) ejection fraction (LVEF, <50%) and a high risk for heart failure (HF) and death. Echocardiography-derived hemodynamic forces (HDFs) may provide important information on LV mechanics, but their prognostic value is unknown. Aim: To explore the features of echocardiography-derived HDFs in NIDCM and their association with clinical endpoints. Methods: Asymptomatic, non-hospitalized NIDCM patients free from coronary artery disease and moderate or severe valvular heart disease were included in this single-center observational retrospective longitudinal study. Those with atrial fibrillation and a follow-up <12 months were excluded. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death, HF hospitalization, and ambulatory intravenous diuretics administration. LV HDFs were analyzed with a prototype software. Apex-base (HDFs-ab), lateral-septal (HDFs-ls), and HDFs-angle were computed. Results: Ninety-seven patients were included, sixty-seven (69%) were males, mean age was 62 ± 14 years, and mean LVEF was 39.2 ± 8.6%. During a median follow-up of 4.2 (3.1–5.1) years, 19 (20%) patients experienced MACE. These patients had a higher HDFs-angle (71.0 (67.0–75.0) vs. 68.0 (63.0–71.0)°, p = 0.005), lower HDFs-ls (1.36 (1.01–1.85) vs. 1.66 ([1.28–2.04])%, p = 0.015), but similar HDFs-ab (5.02 (4.39–6.34) vs. 5.66 (4.53–6.78)%, p = 0.375) compared to those without MACE. in a Cox regression analysis, HDFs-angle (HR 1.16 (95%-CI 1.04–1.30), p = 0.007) was associated with MACE, while other conventional echocardiography parameters, including LVEF and LV longitudinal strain, were not. Conclusions: HDFs-angle is associated with clinical endpoints in NIDCM. A higher HDFs-angle may be a marker of impaired myocardial performance in patients with reduced LVEF.
A.G. has received funding from “La Caixa” Foundation (LCF/BQ/PR22/11920008).
Article
Published version
English
Cor - Ventricle esquerre - Malalties - Factors de risc; Ecocardiografia; Miocardi - Malalties - Imatgeria; Cor - Hipertròfia; Hemodinàmica; PHENOMENA AND PROCESSES::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics; DISEASES::Cardiovascular Diseases::Heart Diseases::Cardiomegaly::Cardiomyopathy, Dilated; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Cardiac Imaging Techniques::Echocardiography; DISEASES::Cardiovascular Diseases::Heart Diseases::Ventricular Dysfunction::Ventricular Dysfunction, Left; FENÓMENOS Y PROCESOS::fenómenos fisiológicos respiratorios y circulatorios::fenómenos fisiológicos cardiovasculares::hemodinámica; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::cardiomegalia::miocardiopatía dilatada; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::técnicas de imagen cardíaca::ecocardiografía; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::disfunción ventricular::disfunción ventricular izquierda
MDPI
Journal of Clinical Medicine;13(13)
https://doi.org/10.3390/jcm13133862
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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