Tadic Marijana, Filipovic Tamara, Suzic Jelena, Majstorovic Anka, Pencic Biljana, Vukomanovic Vladan, Cuspidi Cesare, Celic Vera
Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic-Dedinje", 11000 Belgrade, Serbia.
Faculty of Medicine, Institute for Rehabilitation, University of Belgrade, 11000 Belgrade, Serbia.
J Clin Med. 2024 Sep 28;13(19):5799. doi: 10.3390/jcm13195799.
The aim of the current study was to investigate the predictive value of a multidirectional LV strain on adverse outcomes in a large population of uncomplicated hypertensive patients who were followed for a mean period of 10 years. This retrospective study included 591 recently diagnosed hypertensive patients who underwent clinically indicated echocardiography between January 2010 and December 2014 and were followed for a mean period of 10 years. Global longitudinal, circumferential and radial strains (GLS, GCS and GRS) were measured by 2D speckle tracking imaging. The primary outcome was a MACE occurrence defined by all-cause mortality, cardiovascular mortality, myocardial infarction, coronary artery by-pass, coronary stent implantation, stroke, development of heart failure and the occurrence of atrial fibrillation during follow-up. Our results showed that GLS, GCS and GRS were significantly lower in patients who experienced MACE. Age, male gender, systolic blood pressure, left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) were associated with MACE occurrence. Reduced GLS [OR 1.15; 95%CI: 1.01-1.30] and reduced GCS [OR 1.1; 95%CI: 1.02-1.22] were related with MACE independently of clinical characteristics, LV systolic and diastolic function, as well as LVH. Reduced GRS was not independently associated with adverse outcomes. Reduced GLS and GCS were independently associated with adverse outcomes during 10-year follow-up in patients who were recently diagnosed and uncomplicated hypertensive patients at the baseline.
本研究的目的是在一大群未并发并发症的高血压患者中，调查多方向左心室应变对不良结局的预测价值，这些患者平均随访10年。这项回顾性研究纳入了591例最近诊断为高血压的患者，他们在2010年1月至2014年12月期间接受了临床指征的超声心动图检查，并平均随访了10年。通过二维斑点追踪成像测量整体纵向、圆周和径向应变（GLS、GCS和GRS）。主要结局是随访期间发生的主要不良心血管事件（MACE），定义为全因死亡率、心血管死亡率、心肌梗死、冠状动脉搭桥术、冠状动脉支架植入术、中风、心力衰竭的发生以及房颤的发生。我们的结果显示，发生MACE的患者的GLS、GCS和GRS显著降低。年龄、男性、收缩压、左心室肥厚（LVH）和左心房扩大（LAE）与MACE的发生相关。GLS降低[比值比（OR）1.15；95%置信区间（CI）：1.01-1.30]和GCS降低[OR 1.1；95%CI：1.02-1.22]与MACE相关，独立于临床特征、左心室收缩和舒张功能以及LVH。GRS降低与不良结局无独立相关性。在基线时为新诊断且未并发并发症的高血压患者中，GLS和GCS降低与10年随访期间的不良结局独立相关。
