心脏等容收缩时间是普通人群发生心力衰竭的独立预测因素。
The cardiac isovolumetric contraction time is an independent predictor of incident heart failure in the general population.
作者信息
Alhakak Alia Saed, Møgelvang Rasmus, Schnohr Peter, Modin Daniel, Brainin Philip, Gislason Gunnar, Biering-Sørensen Tor
机构信息
Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
The Copenhagen City Heart Study, Frederiksberg Hospital, University of Copenhagen, Denmark; The Heart Center, Rigshospitalet, University of Copenhagen, Denmark.
出版信息
Int J Cardiol. 2020 Aug 1;312:81-86. doi: 10.1016/j.ijcard.2020.03.046. Epub 2020 Mar 19.
BACKGROUND
Color Tissue Doppler imaging (TDI) M-mode through the mitral leaflet is a novel method to obtain the cardiac time intervals including the isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and ejection time (ET). The myocardial performance index (MPI) is defined as [(IVCT+IVRT)/ET]. Our aim was to investigate if the cardiac time intervals can be used to predict heart failure (HF) in the general population.
METHODS AND RESULTS
A total of 1915 participants (mean age 58 ± 16 years, 42% male) from the general population (The Copenhagen City Heart Study) underwent a health examination including TDI-echocardiography. The primary endpoint was incident HF. Participants with a history of HF were excluded (n = 23). During a median follow-up time of 16 years, 172 (9%) participants were diagnosed with incident HF. The risk of HF increased with 24% per 10 ms increase in IVCT (per 10 ms increase: HR 1.24; 95%CI (1.14-1.36), p < 0.001). The association remained significant after adjusting for age, sex, hypertension, diabetes, previous ischemic heart disease, diastolic blood pressure, heart rate, body mass index, eGFR, proBNP, LVEF <50%, s', LAVI, and E/e' (per 10 ms increase: HR 1.13; 95% CI (1.00-1.27), p = 0.045). A significant association was found between MPI and HF both in unadjusted and adjusted models (per 0.1 increase: HR 6.93; 95% CI (1.63-29.31), p = 0.009). No associations between the IVRT or ET and HF remained significant after multivariable adjustment.
CONCLUSION
In the general population the IVCT provides novel and independent prognostic information on the long-term risk of incident HF.
背景
通过二尖瓣叶的彩色组织多普勒成像（TDI）M型是一种获取心脏时间间期的新方法，这些时间间期包括等容收缩时间（IVCT）、等容舒张时间（IVRT）和射血时间（ET）。心肌性能指数（MPI）定义为[（IVCT + IVRT）/ET]。我们的目的是研究心脏时间间期是否可用于预测普通人群中的心力衰竭（HF）。
方法与结果
来自普通人群（哥本哈根市心脏研究）的1915名参与者（平均年龄58±16岁，42%为男性）接受了包括TDI超声心动图在内的健康检查。主要终点是新发HF。排除有HF病史的参与者（n = 23）。在中位随访时间16年期间，172名（9%）参与者被诊断为新发HF。IVCT每增加10毫秒，HF风险增加24%（每增加10毫秒：HR 1.24；95%CI（1.14 - 1.36），p < 0.001）。在调整年龄、性别、高血压、糖尿病、既往缺血性心脏病、舒张压、心率、体重指数、估算肾小球滤过率、脑钠肽前体、左心室射血分数<50%、s'、左心房容积指数和E/e'后，该关联仍然显著（每增加10毫秒：HR 1.13；95%CI（1.00 - 1.27），p = 0.045）。在未调整和调整模型中均发现MPI与HF之间存在显著关联（每增加0.1：HR 6.93；95%CI（1.63 - 29.31），p = 0.009）。多变量调整后，IVRT或ET与HF之间的关联不再显著。
结论
在普通人群中，IVCT为新发HF的长期风险提供了新的独立预后信息。
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