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Heart failure is an increasingly prevalent condition that grows in incidence with advancing age. Whether systolic strain, a sensitive measure of myocardial function, identifies those predisposed to subsequent heart failure is unclear.
Participants enrolled in the Olmsted County Heart Function Study; a random selected sampling of community subjects who underwent clinical and echocardiographic evaluation between 2001-2004. A random subset of participants (n=301) had assessment of longitudinal left ventricular (LV) systolic strain (Velocity vector imaging, Siemens). Subjects were followed for the development of heart failure over a further 6.3±2.3 years. No subject had a history of heart failure at the time for echocardiography.
The average age was 66±10 years. 51% were female. The prevalence of hypertension and diabetes were 46%, 14% respectively. The mean LV ejection fraction was 67±7. Average global LV longitudinal strain was −19.5±3%. Strain declined with increasing age (1±3% per decade; p<0.001) and was lower in men (−18.7±2.8%) than women (−20.4±3.1%). These associations persisted after adjusting for the presence of hypertension. LV strain was lower in those with diastolic dysfunction (−19.3±3%) compared to those with normal diastolic function (−20.2±3%). Global LV longitudinal systolic strain was associated with the development of incident heart failure; for every 3% decline in strain there was a 3.23-fold increased risk of heart failure (95% CI 2.05-5.13, p<0.001). The association of LV strain with heart failure persisted after adjustment for age, hypertension, diabetes and diastolic dysfunction (hazard ratio 2.77, 95% CI, 1.72-5.54, p<0.001).
In a community-based cohort, global left ventricular systolic strain declines with age and can predict those at risk for the development of subsequent heart failure.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Clinical Applications of Myocardial Mechanics
Abstract Category: 18. Imaging: Echo
Presentation Number: 1268M-339
- 2013 American College of Cardiology Foundation