Cardiac Non-Invasive Imaging Research Laboratory, The Department of Cardiology, Copenhagen University Hospital - Herlev & Gentofte Hospital, Gentofte Hospitalsvej 8, 3. th., 2900 Hellerup, Denmark.
Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen, Denmark.
Eur Heart J Cardiovasc Imaging. 2024 Feb 22;25(3):396-403. doi: 10.1093/ehjci/jead281.
Right ventricular free wall (RVFWLS) and four-chamber longitudinal strain (RV4CLS) are associated with adverse events in various patient populations including patients with heart failure (HF). We sought to investigate the prognostic value of RVFWLS and RV4CLS for the development of incident HF in participants from the general population.
Participants from the 5th Copenhagen City Heart Study (2011-2015) without known chronic ischaemic heart disease or HF at baseline were included. RVFWLS and RV4CLS were obtained using two-dimensional speckle-tracking echocardiography from the right ventricular (RV)-focused apical four-chamber view. The primary endpoint was incident HF. Among 2740 participants (mean age 54 ± 17 years, 42% male), 43 (1.6%) developed HF during a median follow-up of 5.5 years (IQR 4.5-6.3). Both RVFWLS and RV4CLS were associated with an increased risk of incident HF during follow-up independent of age, sex, hypertension, diabetes, body mass index and tricuspid annular plane systolic excursion (TAPSE), (HR 1.06, 95%CI 1.00-1.11, P = 0.034, per 1% absolute decrease and HR 1.14, 95%CI 1.05-1.23, P = 0.001, per 1% absolute decrease, respectively). Left ventricular ejection fraction (LVEF) modified the association between RV4CLS and incident HF (P for interaction = 0.016) such that RV4CLS was only of prognostic importance among those with LVEF < 55% (HR 1.21, 95%CI 1.11-1.33, P < 0.001 vs. HR 0.94, 95%CI 0.80-1.10, P = 0.43 in patients with LVEF ≥ 55%).
In participants from the general population, both RVFWLS and RV4CLS were associated with a greater risk of incident HF independent of important baseline characteristics and TAPSE, and LVEF modified the relationship between RV4CLS and incident HF.
右心室游离壁（RVFWLS）和四腔室纵向应变（RV4CLS）与各种患者群体的不良事件相关，包括心力衰竭（HF）患者。我们旨在研究 RVFWLS 和 RV4CLS 对一般人群中发生 HF 的预测价值。
本研究纳入了来自第 5 届哥本哈根城市心脏研究（2011-2015 年）的参与者，这些参与者在基线时无已知的慢性缺血性心脏病或 HF。使用二维斑点追踪超声心动图从右心室（RV）焦点的 apical 四腔心切面获取 RVFWLS 和 RV4CLS。主要终点是发生 HF。在 2740 名参与者（平均年龄 54±17 岁，42%为男性）中，43 名（1.6%）在中位随访 5.5 年（IQR 4.5-6.3）期间发生 HF。RVFWLS 和 RV4CLS 与随访期间发生 HF 的风险增加独立相关，与年龄、性别、高血压、糖尿病、体重指数和三尖瓣环平面收缩期位移（TAPSE）无关，（HR 1.06，95%CI 1.00-1.11，P=0.034，每 1%绝对减少和 HR 1.14，95%CI 1.05-1.23，P=0.001，每 1%绝对减少）。左心室射血分数（LVEF）改变了 RV4CLS 与 HF 事件之间的关联（P 交互=0.016），因此，RV4CLS 仅在 LVEF <55%的患者中具有预后意义（HR 1.21，95%CI 1.11-1.33，P<0.001 与 LVEF≥55%的患者中 HR 0.94，95%CI 0.80-1.10，P=0.43）。
在一般人群中，RVFWLS 和 RV4CLS 与 HF 事件的发生风险增加独立相关，与重要的基线特征和 TAPSE 无关，LVEF 改变了 RV4CLS 与 HF 事件之间的关系。
