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Echocardiographic screening for non-ischaemic stage B heart failure in the community

Citation

Yang, H and Negishi, K and Wang, Y and Nolan, M and Saito, M and Marwick, TH, Echocardiographic screening for non-ischaemic stage B heart failure in the community, European Journal of Heart Failure, 18, (11) pp. 1331-1339. ISSN 1388-9842 (2016) [Refereed Article]

Copyright Statement

2016 The Authors

DOI: doi:10.1002/ejhf.643

Abstract

AIMS: Incident heart failure (HF) continues to pose a common and serious problem. We sought to examine the value of echocardiographic predictors of new HF in a community-based elderly population at risk for HF, independent of and incremental to clinical evaluation.

METHODS AND RESULTS: Asymptomatic patients ≥65 years old, with ≥1 HF risk factor (hypertension, type 2 diabetes, or obesity) were recruited from the community; patients with valve disease, reduced ejection fraction (EF), and atrial fibrillation (AF) were excluded. Patients underwent standard clinical evaluation including calculation of the Charlson co-morbidity score and a comprehensive echocardiography including global longitudinal strain (GLS). Functional capacity was assessed by 6 min walk test. New HF and cardiovascular death were assessed after a mean follow-up of 14 4 months by three independent cardiologists using Framingham criteria. Of 410 subjects (median age 70 years; 48% men), the prevalence of stage B HF was 13% [by LV hypertrophy (LVH)], 12% (by abnormal E/e'), 33% (by impaired GLS), and 31% [by left atrial enlargement (LAE)]. New HF symptoms developed in 49, and 2 died of cardiovascular causes, giving an event rate of 104/1000 person-years. These patients were older (P = 0.012), had a higher Charlson co-morbidity score (P < 0.001), larger LV mass and left atrium, higher E/e', and lower GLS (P < 0.05). LAE, LVH, abnormal GLS, and E/e' were independent predictors of new HF. In sequential models, LV mass and GLS added incremental information to clinical parameters. GLS significantly reclassified individuals (P = 0.002), but no reclassification improvement was identified using LV mass index, E/e', and left atrial volume index.

CONCLUSION: Echocardiographic assessment (especially GLS and LV mass) provides incremental value in predicting incident HF.

Item Details

Item Type:Refereed Article
Keywords:Community, Echocardiography, Global longitudinal strain, Heart failure, Screening
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Yang, H (Ms Hong Yang)
Author:Negishi, K (Dr Kazuaki Negishi)
Author:Wang, Y (Ms Ying Wang)
Author:Nolan, M (Mr Mark Nolan)
Author:Saito, M (Dr Makoto Saito)
Author:Marwick, TH (Professor Tom Marwick)
ID Code:112523
Year Published:2016
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-11-15
Last Modified:2017-11-03
Downloads:0

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