PMID- 31965750
OWN - NLM
STAT- MEDLINE
DCOM- 20210413
LR  - 20210413
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 7
IP  - 1
DP  - 2020 Feb
TI  - Synergistic prognostication of left ventricular hypertrophy and three-dimensional 
      mechanical dyssynchrony in heart failure.
PG  - 361-370
LID - 10.1002/ehf2.12578 [doi]
AB  - AIMS: In this study, we investigated the prognostic interplay of left ventricular 
      hypertrophy and mechanical dyssynchrony (LVMD), both of which can be measured 
      three-dimensionally by gated myocardial perfusion imaging (MPI), in patients with 
      chronic systolic heart failure (HF). METHODS AND RESULTS: In 829 consecutive HF 
      patients with reduced left ventricular ejection fraction less than 50%, LVMD was 
      evaluated as a standard deviation (phase SD) of regional onset of mechanical 
      contraction phase angles. A phase histogram was created by Fourier phase analysis 
      applied to regional time-activity curves obtained by gated MPI. Left ventricular 
      mass index (LVMI) was measured by Corridor 4DM version 6.0. Patients were 
      followed up with a primary endpoint of lethal cardiac events (CE) for a mean 
      interval of 34 months. CE were documented in 223 (27%) of the HF patients. The CE 
      group had a greater phase SD and a greater LVMI than those in the non-CE group. 
      Patients in the CE group had a more advanced age, greater New York Heart 
      Association (NYHA) functional class, left ventricular cavity size, and left 
      atrial diameter or septal E/e' and lower kidney or cardiac function than did 
      patients in the non-CE group. Phase SD > 37 and LVMI > 122.7 g/m(2) were 
      identified as optimal cut-off values by receiver operating characteristic 
      analyses for discrimination of the most increased risk HF subgroup from others (P 
      < 0.0001). When classified into four patient subgroups using both cut-off values, 
      HF patients with phase SD > 37 (LVMD) and LVMI > 122.7g/m(2) had the highest CE 
      rate among the subgroups (P < 0.0001). Univariate analysis and subsequent 
      multivariate analysis with a Cox proportional hazards model showed that phase SD 
      and LVMI were significant independent predictors of CE with hazard ratios of 
      1.038 (confidence interval [CI], 1.024-1.051, P < 0.0001) and 1.005 (CI, 
      1.001-1.008, P = 0.0073), respectively, as well as conventional clinical 
      parameters such as age, NYHA class, estimated glomerular filtration rate (eGFR), 
      and BNP concentration. Patients with increased phase SD and LVMI had 
      incrementally improved prognostic values of clinical parameters including age, 
      NYHA functional class, eGFR, and BNP with increases in the global chi(2) value: 5.9 
      for age; 139.5 for age and NYHA; 157.9 for age, NYHA, and eGFR; 163.9 for age, 
      NYHA, eGFR, and BNP; 183.4 for age, NYHA, eGFR, BNP, and phase SD; and 192.5 for 
      age, NYHA, eGFR, BNP, phase SD, and LVMI. CONCLUSIONS: Three-dimensionally 
      assessed LVMD has independent prognostic values and can improve the risk 
      stratification of chronic HF patients synergistically in combination with 
      conventional clinical parameters.
CI  - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Doi, Takahiro
AU  - Doi T
AD  - Department of Cardiology, Teine-Keijinkai General Hospital, Sapporo, Japan.
FAU - Nakata, Tomoaki
AU  - Nakata T
AD  - Department of Cardiology, Hakodate Goryokaku Hospital, Hakodate, Japan.
FAU - Yuda, Satoshi
AU  - Yuda S
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical 
      University, Sapporo, Japan.
FAU - Hashimoto, Akiyoshi
AU  - Hashimoto A
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical 
      University, Sapporo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200121
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Systolic/diagnosis/*etiology/physiopathology
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Hypertrophy, Left Ventricular/complications/*diagnosis/physiopathology
MH  - Imaging, Three-Dimensional/*methods
MH  - Male
MH  - Myocardial Perfusion Imaging/*methods
MH  - Prognosis
MH  - Retrospective Studies
MH  - Time Factors
MH  - Ventricular Function, Left/*physiology
PMC - PMC7083410
OTO - NOTNLM
OT  - Cardiac mortality
OT  - Left ventricular hypertrophy
OT  - Mechanical dyssynchrony
OT  - Systolic heart failure
COIS- None declared.
EDAT- 2020/01/23 06:00
MHDA- 2021/04/14 06:00
PMCR- 2020/01/21
CRDT- 2020/01/23 06:00
PHST- 2019/07/08 00:00 [received]
PHST- 2019/10/07 00:00 [revised]
PHST- 2019/11/11 00:00 [accepted]
PHST- 2020/01/23 06:00 [pubmed]
PHST- 2021/04/14 06:00 [medline]
PHST- 2020/01/23 06:00 [entrez]
PHST- 2020/01/21 00:00 [pmc-release]
AID - EHF212578 [pii]
AID - 10.1002/ehf2.12578 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2020 Feb;7(1):361-370. doi: 10.1002/ehf2.12578. Epub 2020 Jan 21.