Echocardiography-Derived Hemodynamic Forces Are Associated with Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy
Cesareo, Marco (University of Turin)
Ródenas-Alesina, Eduard (Universitat Autònoma de Barcelona. Departament de Medicina)
Guala, Andrea (Vall d'Hebron Institut de Recerca (VHIR))
Lozano-Torres, Jordi (Hospital Universitari Vall d'Hebron)
Casas, Guillem (Universitat Autònoma de Barcelona. Departament de Medicina)
Vallelonga, Fabrizio (University of Turin)
Airale, Lorenzo (University of Turin)
Ferreira-Gonzalez, Ignacio (Universitat Autònoma de Barcelona. Departament de Medicina)
Milan, Alberto (University of Turin)
Rodríguez Palomares, José F. (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2024
Resum:	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.
Ajuts:	"la Caixa" Foundation LCF/BQ/PR22/11920008
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hemodynamic forces ; Intraventricular pressure gradients ; Echocardiography ; Dilated cardiomyopathy ; Speckle tracking
Publicat a:	Journal of clinical medicine, Vol. 13 (june 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13133862
PMID: 38999432

16 p, 1.8 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats