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We present a novel study to test the ability of three-dimensional speckle tracking echocardiography to predict adverse cardiac events in patients with left ventricular (LV) dysfunction.
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Patients with ischaemic and non-ischaemic LV dysfunction were studied and compared.
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Cardiac magnetic resonance (CMR) with delayed contrast enhancement (DCE), a well-studied imaging modality, was used for this purpose.
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A relatively new objective method of quantifying DCE-CMR was applied according to the most recent recommendation.
Introduction
Methods
Study design and population
CMR and echocardiographic analysis
Cardiac events
Statistical analysis
Results
Patients’ characteristics
Variable | Cardiac events | p‑value | |
---|---|---|---|
Yes (n = 44, 39%) | No (n = 69, 61%) | ||
Patients’ characteristics | |||
Age (years) | 64 ± 11 | 61 ± 14 | 0.115 |
Male (n, %) | 33, 75 | 48, 70 | 0.532 |
HR (bpm) | 67 ± 6 | 66 ± 5 | 0.785 |
BSA (kg/m2) | 1.9 ± 0.2 | 1.9 ± 0.2 | 0.789 |
Hypertension (n, %) | 22, 50 | 26, 38 | 0.196 |
Diabetes mellitus (n, %) | 7, 16 | 12, 17 | 0.837 |
Patients with CRT/ICD/CRT‑D | 22, 29 | 12, 32 | 0.806 |
Duration of follow-up | 42 ± 9 | 41 ± 8 | 0.737 |
Ischaemic LV dysfunction (n, %) | 35, 80 | 40, 58 | 0.018* |
CMR | |||
LVEDV (ml) | 218 ± 61 | 207 ± 65 | 0.345 |
LVESV (ml) | 145 ± 64 | 126 ± 62 | 0.136 |
LVEF (%) | 36 ± 12 | 41 ± 13 | 0.023* |
LV mass (g) | 114 ± 30 | 114 ± 37 | 0.972 |
DCE | |||
Positive (n, %) | 31, 41 | 44, 59 | 0.463 |
Enhanced mass (g) | 114 ± 30 | 114 ± 37 | 0.390 |
% Enhanced mass | 12 ± 12 | 10 ± 13 | 0.390 |
3DSTE | |||
LVEDV (ml) | 164 ± 60 | 145 ± 49 | 0.086 |
LVESV (ml) | 113 ± 61 | 89 ± 46 | 0.019* |
LVEF (%) | 34 ± 13 | 41 ± 13 | 0.008* |
LV mass (g) | 169 ± 42 | 151 ± 35 | 0.018* |
GLS (%) | −9 ± 4 | −10 ± 4 | 0.129 |
GCS (%) | −15 ± 6 | −18 ± 7 | 0.034* |
GRS (%) | 18 ± 10 | 20 ± 9 | 0.219 |
GAS (%) | −22 ± 8 | −26 ± 9 | 0.017* |
3DSTE and CMR risk parameters for cardiac events
(I) Ischaemic patients (n = 74) | Patients with cardiac events (n = 35, 47%) | Patients without cardiac events (n = 39, 53%) | p‑value |
CMR | |||
LVEF (%) | 33 ± 12 | 43 ± 12 | 0.041* |
3D STE | |||
LVEF (%) | 36 ± 13 | 42 ± 12 | 0.027* |
LVESV (ml) | 108 ± 63 | 82 ± 41 | 0.036* |
LV mass (g) | 169 ± 43 | 149 ± 35 | 0.031* |
GCS (%) | −16 ± 6 | −18 ± 7 | 0.120 |
GAS (%) | −23 ± 8 | −27 ± 9 | 0.520 |
(II) Non-ischaemic patients (n = 38) | Patients with cardiac events (n = 8, 21%) | Patients without cardiac events (n = 30, 79%) | p‑value |
CMR | |||
LVEF (%) | 29 ± 13 | 40 ± 14 | 0.048* |
3D STE | |||
LVEF (%) | 29 ± 14 | 40 ± 14 | 0.049* |
LVESV (ml) | 135 ± 53 | 98 ± 51 | 0.074 |
LV mass (g) | 171 ± 40 | 155 ± 36 | 0.270 |
GCS (%) | −11 ± 6.2 | −17 ± 8 | 0.066 |
GAS (%) | −19 ± 9 | −26 ± 10 | 0.078 |
Cardiac events
Cardiac event | n |
---|---|
Mortality | 9 |
Cardiac cause | 3 |
Non-cardiac cause | 3 |
Unknown cause | 3 |
Hospitalisation for heart failure | 9 |
Myocardial infarction | 12 |
STEMI | 3 |
NSTEMI | 9 |
Revascularisation | 20 |
Urgent PCI | 4 |
Elective PCI | 7 |
Elective CABG | 9 |
New device implantation | 11 |
CRT/CRT‑D | 5 |
ICD | 6 |