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Updated: Aug 19, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Identification of echocardiographic subgroups in patients with coronary heart disease combined with heart failure
Yutao Du1, Na Yuan1, Jingjing Yan1
1Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001, China.
Insights
Patients with coronary heart disease and chronic heart failure can be classified into three echocardiographic subgroups. The eccentric hypertrophy group faces the highest mortality risk, highlighting the importance of subgrouping for personalized interventions.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Chronic heart failure (CHF) carries a poor prognosis, necessitating improved patient classification for personalized treatment.
- Classifying patients with coronary heart disease (CHD) and CHF remains a clinical challenge.
- Echocardiographic indices offer a potential tool for subgrouping these patients.
Purpose of the Study:
- To identify distinct patient subgroups within the cohort of coronary heart disease and chronic heart failure patients.
- To explore the prognostic value of echocardiographic indices for patient stratification.
- To investigate the relationship between identified subgroups and patient mortality.
Main Methods:
- Latent class analysis was employed to group 5126 patients based on echocardiographic data.
- Network maps and radar charts visualized echocardiographic index distributions.
- Kaplan-Meier curves and Cox regression models assessed mortality risk across subgroups.
Main Results:
- Three patient subgroups emerged: eccentric hypertrophy, concentric hypertrophy, and decreased diastolic function.
- The eccentric hypertrophy group exhibited significant correlations between left atrial diameter, left ventricular mass index, and ejection fraction.
- Mortality risk was significantly different across subgroups (P < 0.001), with eccentric hypertrophy showing the highest risk (HR = 1.586).
Conclusions:
- Echocardiographic indices enable the classification of CHD and CHF patients into three prognostically relevant subgroups.
- Subgrouping based on echocardiography is an independent predictor of mortality in this patient population.
- Accurate echocardiographic subgrouping is crucial for identifying high-risk patients and guiding personalized interventions.
Background:
The prognosis of chronic heart failure is poor, and it remains a challenge to classify patients for better personalized intervention. This study aimed to explore potential subgroups in patients with coronary heart disease and chronic heart failure using comprehensive echocardiographic indices.
Methods:
5126 patients with coronary heart disease with chronic heart failure were included. Latent class analysis was applied to identify the grouping patterns of patients based on echocardiographic indices. Network maps and radar charts of echocardiographic indices were drawn to visualize the distribution of echocardiographic findings. The incidence of adverse outcomes was presented on the Kaplan-Meier curve and compared using the log-rank test. The Cox regression model was used to analyze the relationship between subgroups and mortality.
Results:
Three groups were identified: eccentric hypertrophy, concentric hypertrophy, and decreased diastolic function. Network plots showed a higher correlation between left atrial diameter, left ventricular mass index, and left ventricle ejection fraction in the eccentric hypertrophy group than in the other groups. The Kaplan-Meier curve showed a significant difference in mortality between the three subgroups (P < 0.001). Multivariate Cox analysis indicated that the eccentric hypertrophy group had the highest risk of death (HR = 1.586, 95% CI: 1.310-1.921, P < 0.001) compared with the other groups.
Conclusion:
Patients with coronary heart disease and chronic heart failure can be classified into three subgroups based on echocardiographic indices. This grouping has been shown to be an independent risk factor for mortality in these patients. Accurate subgrouping based on echocardiographic indices is important for identifying high-risk patients.
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