Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.
Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, 2900, Hellerup, Denmark.
Int J Cardiovasc Imaging. 2024 Oct;40(10):2145-2155. doi: 10.1007/s10554-024-03206-8. Epub 2024 Aug 3.
Cardiac time intervals are sensitive markers of myocardial dysfunction that predispose to heart failure (HF). We aimed to investigate the association between cardiac time intervals and HF in patients with acute coronary syndrome (ACS).
This study included 386 ACS patients treated with percutaneous coronary intervention (PCI). Patients underwent an echocardiography examination a median of two days after PCI. Cardiac time intervals including isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), and systolic ejection time (ET), and myocardial performance index (MPI) were obtained by tissue Doppler echocardiography. The outcome was incident HF.
During follow-up (median 4.3, IQR:1.0-6.7 years), 140 (36%) developed HF. In unadjusted analyses, IVRT was not associated with HF (HR 1.02 (0.95-1.10), p = 0.61, per 10ms increase), and neither was IVCT (HR 0.07 (0.95-1.22), p = 0.26, per 10ms increase). Increasing MPI was associated with a higher risk of HF (HR 1.20 (1.08-1.34), P = 0.001, per 0.1 increase), and so was decreasing ET (HR 1.13 (1.07-1.18), P < 0.001 per 10ms decrease). After multivariable adjustment for cardiovascular risk factors, MPI (HR 1.13 (1.01-1.27), P = 0.034) and ET (HR 1.09 (1.01-1.17), P = 0.025) remained significantly associated with incident HF. LVEF modified the association between ET and HF (p for interaction = 0.002), such that ET was associated with HF in patients with LVEF ≥ 36% (HR = 1.15 (1.06-1.24), P = 0.001, per 10ms decrease).
In patients admitted with ACS, shortened ET and higher MPI were independently associated with an increased risk of incident HF. Additionally, ET was associated with incident HF in patients with LVEF above 36%.
心脏时间间期是心肌功能障碍的敏感标志物，易导致心力衰竭（HF）。我们旨在研究急性冠状动脉综合征（ACS）患者中心脏时间间期与 HF 之间的关系。
本研究纳入了 386 名接受经皮冠状动脉介入治疗（PCI）的 ACS 患者。患者在 PCI 后中位数为 2 天进行了超声心动图检查。组织多普勒超声心动图获得了等容舒张时间（IVRT）、等容收缩时间（IVCT）和收缩射血时间（ET）以及心肌做功指数（MPI）等心脏时间间期。结果为新发 HF。
在随访期间（中位数 4.3 年，IQR：1.0-6.7 年），140 例（36%）发生 HF。在未调整分析中，IVRT 与 HF 无关（HR 1.02（0.95-1.10），p=0.61，每增加 10ms），IVCT 也无关（HR 0.07（0.95-1.22），p=0.26，每增加 10ms）。MPI 增加与 HF 风险增加相关（HR 1.20（1.08-1.34），P=0.001，每增加 0.1 个单位），ET 减少也与 HF 相关（HR 1.13（1.07-1.18），P<0.001，每减少 10ms）。对心血管危险因素进行多变量调整后，MPI（HR 1.13（1.01-1.27），P=0.034）和 ET（HR 1.09（1.01-1.17），P=0.025）与新发 HF 仍显著相关。LVEF 改变了 ET 与 HF 之间的关联（交互作用的 P 值=0.002），因此，在 LVEF≥36%的患者中，ET 与 HF 相关（HR=1.15（1.06-1.24），P=0.001，每减少 10ms）。
在因 ACS 入院的患者中，缩短 ET 和升高的 MPI 与新发 HF 的风险增加独立相关。此外，在 LVEF 高于 36%的患者中，ET 与新发 HF 相关。
