Feasibility and prognostic significance ...
Document type :
Article dans une revue scientifique: Article original
DOI :
Title :
Feasibility and prognostic significance of ventricular–arterial coupling after myocardial infarction: the RIGID-MI cohort
Author(s) :
Aghezzaf, Samy [Auteur]
Coisne, Augustin [Auteur]
Bauters, Christophe [Auteur]
Favata, Francesco [Auteur]
Delsart, Pascal [Auteur]
Coppin, Amandine [Auteur]
Seunes, Claire [Auteur]
Schurtz, Guillaume [Auteur]
Verdier, Basile [Auteur]
Lamblin, Nicolas [Auteur]
Tazibet, Amine [Auteur]
Le Taillandier de Gabory, Justine [Auteur]
Ninni, Sandro [Auteur]
Donal, Erwan [Auteur]
Lemesle, Gilles [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Montaigne, David [Auteur]
Coisne, Augustin [Auteur]
Bauters, Christophe [Auteur]
Favata, Francesco [Auteur]
Delsart, Pascal [Auteur]
Coppin, Amandine [Auteur]
Seunes, Claire [Auteur]
Schurtz, Guillaume [Auteur]
Verdier, Basile [Auteur]
Lamblin, Nicolas [Auteur]
Tazibet, Amine [Auteur]
Le Taillandier de Gabory, Justine [Auteur]
Ninni, Sandro [Auteur]
Donal, Erwan [Auteur]
Lemesle, Gilles [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Montaigne, David [Auteur]
Journal title :
European Heart Journal - Cardiovascular Imaging
Publisher :
Oxford UP
Publication date :
2023-12-22
ISSN :
2047-2404
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Abstract Aims The clinical significance and feasibility of the recently described non-invasive parameters exploring ventricular–arterial coupling (VAC) remain uncertain. This study aimed to assess VAC parameters for ...
Show more >Abstract Aims The clinical significance and feasibility of the recently described non-invasive parameters exploring ventricular–arterial coupling (VAC) remain uncertain. This study aimed to assess VAC parameters for prognostic stratification in stable patients with left ventricular ejection fraction (LVEF) ≥40% following myocardial infarction (MI). Methods and results Between 2018 and 2021, patients with LVEF ≥40% were evaluated 1 month following MI using transthoracic echocardiography (TTE) and arterial tonometry at rest and after a handgrip test. VAC was studied via the ratio between arterial elastance (Ea) and end-systolic LV elastance (Ees) and between pulse wave velocity (PWV) and global longitudinal strain (GLS). Patients were followed for major adverse cardiovascular events (MACE): all-cause death, acute heart failure, stroke, AMI, and urgent cardiovascular hospitalization. Among the 374 patients included, Ea/Ees and PWV/GLS were obtained at rest for 354 (95%) and 253 patients (68%), respectively. Isometric exercise was workable in 335 patients (85%). During a median follow-up of 32 months (interquartile range: 16–42), 41 (11%) MACE occurred. Patients presenting MACE were significantly older and had a higher prevalence of peripheral arterial disease, lower GLS, higher Ea, PWV, and PWV/GLS ratio. The Ea/Ees ratio and standard TTE parameters during isometric exercise were not associated with MACE. After adjustment, the PWV/GLS ratio was the only VAC parameter independently associated with outcome. Receiver operating characteristic curve analysis identified a PWV/GLS ratio >0.70 (Youden’s index = 0.37) as the best threshold to identify patients developing MACE: hazard ratio (95% confidence interval) = 2.2 (1.14–4.27), P = 0.02. Conclusion The PWV/GLS ratio, assessed 1 month after MI, identifies a group of patients at higher risk of MACE providing additional value on top of conventional non-invasive parameters.Show less >
Show more >Abstract Aims The clinical significance and feasibility of the recently described non-invasive parameters exploring ventricular–arterial coupling (VAC) remain uncertain. This study aimed to assess VAC parameters for prognostic stratification in stable patients with left ventricular ejection fraction (LVEF) ≥40% following myocardial infarction (MI). Methods and results Between 2018 and 2021, patients with LVEF ≥40% were evaluated 1 month following MI using transthoracic echocardiography (TTE) and arterial tonometry at rest and after a handgrip test. VAC was studied via the ratio between arterial elastance (Ea) and end-systolic LV elastance (Ees) and between pulse wave velocity (PWV) and global longitudinal strain (GLS). Patients were followed for major adverse cardiovascular events (MACE): all-cause death, acute heart failure, stroke, AMI, and urgent cardiovascular hospitalization. Among the 374 patients included, Ea/Ees and PWV/GLS were obtained at rest for 354 (95%) and 253 patients (68%), respectively. Isometric exercise was workable in 335 patients (85%). During a median follow-up of 32 months (interquartile range: 16–42), 41 (11%) MACE occurred. Patients presenting MACE were significantly older and had a higher prevalence of peripheral arterial disease, lower GLS, higher Ea, PWV, and PWV/GLS ratio. The Ea/Ees ratio and standard TTE parameters during isometric exercise were not associated with MACE. After adjustment, the PWV/GLS ratio was the only VAC parameter independently associated with outcome. Receiver operating characteristic curve analysis identified a PWV/GLS ratio >0.70 (Youden’s index = 0.37) as the best threshold to identify patients developing MACE: hazard ratio (95% confidence interval) = 2.2 (1.14–4.27), P = 0.02. Conclusion The PWV/GLS ratio, assessed 1 month after MI, identifies a group of patients at higher risk of MACE providing additional value on top of conventional non-invasive parameters.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Source :