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Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes

Susan Cheng1, Elizabeth L McCabe2, Martin G Larson3

  • 1Framingham Heart Study, Framingham, MA (S.C., M.G.L., E.O., B.T.L., P.S., E.J.B., R.S.V.) Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.C., A.A.M., S.D.S.).

Journal of the American Heart Association
|October 29, 2015
PubMed

Insights

Distinct left ventricular (LV) mechanical function measures predict specific cardiovascular disease outcomes. Circumferential strain predicts heart failure, while all strain types relate to mortality.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Disease Research

Background:

  • Limited data exist on novel left ventricular (LV) mechanical function measures and community cardiovascular disease (CVD) outcomes.
  • The specific predictive value of distinct LV mechanical function components for different CVD outcomes remains unclear.

Purpose of the Study:

  • To investigate the association between distinct components of LV mechanical function and specific CVD outcomes in a community-based cohort.
  • To determine if novel echocardiographic measures of LV strain offer prognostic information beyond conventional metrics.

Main Methods:

  • Speckle tracking echocardiography was used to quantify LV strain in multiple planes in 2831 participants from the Framingham Offspring Study.
  • Participants were followed for incident coronary heart disease (CHD), heart failure (HF), and mortality events.
  • Analyses adjusted for traditional CVD risk factors and echocardiographic measures like LV mass and fractional shortening.

Main Results:

  • Circumferential LV strain was a significant predictor of incident heart failure (HF).
  • Longitudinal LV strain showed a trend towards association with incident coronary heart disease (CHD), but was not significant after correction.
  • Decrements in circumferential, radial, and longitudinal strain were all associated with all-cause mortality.

Conclusions:

  • Distinct components of LV mechanical function are associated with specific CVD outcomes in a large community sample.
  • These findings highlight the potential prognostic utility of novel LV strain measures.
  • Further research is needed to validate these results and explore their therapeutic implications.
Abstract

Keywords:
cardiovascular diseaseleft ventricular strainoutcomes

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