Importance and inter-relationship of tissue Doppler variables for predicting adverse outcomes in high-risk patients: an analysis of 388 diabetic patients referred for coronary angiography
To investigate the relative importance of individual tissue Doppler imaging variables to predict adverse events in a high-risk population with diabetes, ischaemic heart disease, and/or systolic dysfunction. Transthoracic echocardiograms were analysed in 388 diabetic patients without significant valv...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2012-08, Vol.13 (8), p.643-649 |
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| creator | Andersson, Charlotte Gislason, Gunnar H Møgelvang, Rasmus Hoffmann, Søren Mérie, Charlotte Køber, Lars Torp-Pedersen, Christian Søgaard, Peter |
| description | To investigate the relative importance of individual tissue Doppler imaging variables to predict adverse events in a high-risk population with diabetes, ischaemic heart disease, and/or systolic dysfunction.
Transthoracic echocardiograms were analysed in 388 diabetic patients without significant valve disease, bundle branch block, and atrial fibrillation who underwent coronary angiography. Multivariable Cox's regression analyses were used to establish the association between peak systolic (s'), early diastolic (e'), and late diastolic (a') tissue velocities and outcomes (hospitalization for heart failure or death). The mean age and left ventricular ejection fraction (LVEF) was 66±10 years and 45±12%, respectively. During 2.3 (±1.0) years of follow-up, 91 patients (24%) met the combined endpoint. After adjustment for LVEF, coronary artery pathology, heart failure at baseline, age, and gender, each 1 cm/s decrease in s', e', and a' was associated with a hazard ratio (HR) of 1.18 (0.89-1.57), 1.03 (0.86-1.22), and 1.20 (1.05-1.37), respectively. A significant interaction was found between s' and a', P |
| doi_str_mv | 10.1093/ejechocard/jer297 |
| format | Article |
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Transthoracic echocardiograms were analysed in 388 diabetic patients without significant valve disease, bundle branch block, and atrial fibrillation who underwent coronary angiography. Multivariable Cox's regression analyses were used to establish the association between peak systolic (s'), early diastolic (e'), and late diastolic (a') tissue velocities and outcomes (hospitalization for heart failure or death). The mean age and left ventricular ejection fraction (LVEF) was 66±10 years and 45±12%, respectively. During 2.3 (±1.0) years of follow-up, 91 patients (24%) met the combined endpoint. After adjustment for LVEF, coronary artery pathology, heart failure at baseline, age, and gender, each 1 cm/s decrease in s', e', and a' was associated with a hazard ratio (HR) of 1.18 (0.89-1.57), 1.03 (0.86-1.22), and 1.20 (1.05-1.37), respectively. A significant interaction was found between s' and a', P<0.01. In patients with lower than mean s', 1 cm/s decrease in a' was associated with HR 1.31 (1.10-1.55, P<0.01), whereas a' was without prognostic importance in patients with higher than mean s' [HR 0.99 (0.78-1.25, P=0.6)]. Patients having lower than mean values of both s' and a' had a poorer prognosis than patients having at least one of s' and a' high.
Peak systolic and late diastolic tissue velocities add prognostic information beyond LVEF in high-risk patients. Variables should be considered together as they interact on prognosis.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ejechocard/jer297</identifier><identifier>PMID: 22207342</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Cardiovascular Diseases - diagnostic imaging ; Chi-Square Distribution ; Coronary Angiography ; Denmark ; Diastole ; Echocardiography, Doppler ; Female ; Humans ; Male ; Predictive Value of Tests ; Proportional Hazards Models ; Registries ; Retrospective Studies ; Risk Assessment ; Systole</subject><ispartof>European heart journal cardiovascular imaging, 2012-08, Vol.13 (8), p.643-649</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-4f676382816a20b70887a8074e3d41a192e6123ccb013932abebc95e7aea84cf3</citedby><cites>FETCH-LOGICAL-c344t-4f676382816a20b70887a8074e3d41a192e6123ccb013932abebc95e7aea84cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22207342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersson, Charlotte</creatorcontrib><creatorcontrib>Gislason, Gunnar H</creatorcontrib><creatorcontrib>Møgelvang, Rasmus</creatorcontrib><creatorcontrib>Hoffmann, Søren</creatorcontrib><creatorcontrib>Mérie, Charlotte</creatorcontrib><creatorcontrib>Køber, Lars</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Søgaard, Peter</creatorcontrib><title>Importance and inter-relationship of tissue Doppler variables for predicting adverse outcomes in high-risk patients: an analysis of 388 diabetic patients referred for coronary angiography</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>To investigate the relative importance of individual tissue Doppler imaging variables to predict adverse events in a high-risk population with diabetes, ischaemic heart disease, and/or systolic dysfunction.
Transthoracic echocardiograms were analysed in 388 diabetic patients without significant valve disease, bundle branch block, and atrial fibrillation who underwent coronary angiography. Multivariable Cox's regression analyses were used to establish the association between peak systolic (s'), early diastolic (e'), and late diastolic (a') tissue velocities and outcomes (hospitalization for heart failure or death). The mean age and left ventricular ejection fraction (LVEF) was 66±10 years and 45±12%, respectively. During 2.3 (±1.0) years of follow-up, 91 patients (24%) met the combined endpoint. After adjustment for LVEF, coronary artery pathology, heart failure at baseline, age, and gender, each 1 cm/s decrease in s', e', and a' was associated with a hazard ratio (HR) of 1.18 (0.89-1.57), 1.03 (0.86-1.22), and 1.20 (1.05-1.37), respectively. A significant interaction was found between s' and a', P<0.01. In patients with lower than mean s', 1 cm/s decrease in a' was associated with HR 1.31 (1.10-1.55, P<0.01), whereas a' was without prognostic importance in patients with higher than mean s' [HR 0.99 (0.78-1.25, P=0.6)]. Patients having lower than mean values of both s' and a' had a poorer prognosis than patients having at least one of s' and a' high.
Peak systolic and late diastolic tissue velocities add prognostic information beyond LVEF in high-risk patients. Variables should be considered together as they interact on prognosis.</description><subject>Aged</subject><subject>Cardiovascular Diseases - diagnostic imaging</subject><subject>Chi-Square Distribution</subject><subject>Coronary Angiography</subject><subject>Denmark</subject><subject>Diastole</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Systole</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1u3SAQhVHVqonSPEA3Fcts3PAXG3cXpfmTImWTri2Mx9fc2kAHHOk-W16upDe5RUiMxDnfDBxCvnL2nbNWnsMW7BSsweF8Cyja5gM5Fkw1lVBcfDzUTB2R05S2rKwLVSvBP5MjIQRrpBLH5OV-iQGz8Rao8QN1PgNWCLPJLvg0uUjDSLNLaQX6M8Q4A9Jng870MyQ6BqQRYXA2O7-hZngGTEDDmm1Yyr3zdHKbqUKXftNYmOBz-lE6lW3mXXLpFS-1pkMhQnb2oKIII2Bh_2tiAwZvcFd8Gxc2aOK0-0I-jWZOcPp2npBfN9dPV3fVw-Pt_dXlQ2WlUrlSY93UUgvNayNY3zCtG6NZo0AOihveCqi5kNb2jMtWijJHb9sLaAwYrewoT8jZnhsx_Fkh5W5xycI8Gw9hTR1nonysVFoUKd9LLYaUygu6iG4pcxdR9xpb9z-2bh9b8Xx7w6_9AsPB8R6S_AvbFZt8</recordid><startdate>201208</startdate><enddate>201208</enddate><creator>Andersson, Charlotte</creator><creator>Gislason, Gunnar H</creator><creator>Møgelvang, Rasmus</creator><creator>Hoffmann, Søren</creator><creator>Mérie, Charlotte</creator><creator>Køber, Lars</creator><creator>Torp-Pedersen, Christian</creator><creator>Søgaard, Peter</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201208</creationdate><title>Importance and inter-relationship of tissue Doppler variables for predicting adverse outcomes in high-risk patients: an analysis of 388 diabetic patients referred for coronary angiography</title><author>Andersson, Charlotte ; Gislason, Gunnar H ; Møgelvang, Rasmus ; Hoffmann, Søren ; Mérie, Charlotte ; Køber, Lars ; Torp-Pedersen, Christian ; Søgaard, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-4f676382816a20b70887a8074e3d41a192e6123ccb013932abebc95e7aea84cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Cardiovascular Diseases - diagnostic imaging</topic><topic>Chi-Square Distribution</topic><topic>Coronary Angiography</topic><topic>Denmark</topic><topic>Diastole</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Systole</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersson, Charlotte</creatorcontrib><creatorcontrib>Gislason, Gunnar H</creatorcontrib><creatorcontrib>Møgelvang, Rasmus</creatorcontrib><creatorcontrib>Hoffmann, Søren</creatorcontrib><creatorcontrib>Mérie, Charlotte</creatorcontrib><creatorcontrib>Køber, Lars</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Søgaard, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersson, Charlotte</au><au>Gislason, Gunnar H</au><au>Møgelvang, Rasmus</au><au>Hoffmann, Søren</au><au>Mérie, Charlotte</au><au>Køber, Lars</au><au>Torp-Pedersen, Christian</au><au>Søgaard, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Importance and inter-relationship of tissue Doppler variables for predicting adverse outcomes in high-risk patients: an analysis of 388 diabetic patients referred for coronary angiography</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2012-08</date><risdate>2012</risdate><volume>13</volume><issue>8</issue><spage>643</spage><epage>649</epage><pages>643-649</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>To investigate the relative importance of individual tissue Doppler imaging variables to predict adverse events in a high-risk population with diabetes, ischaemic heart disease, and/or systolic dysfunction.
Transthoracic echocardiograms were analysed in 388 diabetic patients without significant valve disease, bundle branch block, and atrial fibrillation who underwent coronary angiography. Multivariable Cox's regression analyses were used to establish the association between peak systolic (s'), early diastolic (e'), and late diastolic (a') tissue velocities and outcomes (hospitalization for heart failure or death). The mean age and left ventricular ejection fraction (LVEF) was 66±10 years and 45±12%, respectively. During 2.3 (±1.0) years of follow-up, 91 patients (24%) met the combined endpoint. After adjustment for LVEF, coronary artery pathology, heart failure at baseline, age, and gender, each 1 cm/s decrease in s', e', and a' was associated with a hazard ratio (HR) of 1.18 (0.89-1.57), 1.03 (0.86-1.22), and 1.20 (1.05-1.37), respectively. A significant interaction was found between s' and a', P<0.01. In patients with lower than mean s', 1 cm/s decrease in a' was associated with HR 1.31 (1.10-1.55, P<0.01), whereas a' was without prognostic importance in patients with higher than mean s' [HR 0.99 (0.78-1.25, P=0.6)]. Patients having lower than mean values of both s' and a' had a poorer prognosis than patients having at least one of s' and a' high.
Peak systolic and late diastolic tissue velocities add prognostic information beyond LVEF in high-risk patients. Variables should be considered together as they interact on prognosis.</abstract><cop>England</cop><pmid>22207342</pmid><doi>10.1093/ejechocard/jer297</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cardiovascular Diseases - diagnostic imaging Chi-Square Distribution Coronary Angiography Denmark Diastole Echocardiography, Doppler Female Humans Male Predictive Value of Tests Proportional Hazards Models Registries Retrospective Studies Risk Assessment Systole |
| title | Importance and inter-relationship of tissue Doppler variables for predicting adverse outcomes in high-risk patients: an analysis of 388 diabetic patients referred for coronary angiography |
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