What is the clinical evidence from this study?

Study design: Observational. Population: Non-ischemic dilated cardiomyopathy (n=91). Intervention: Reduced LV torsion ( 0.59 degrees/cm). Primary outcome: Hospital admission for worsening heart failure (HR 6.41, 95% CI 2.19-18.83, p=<0.001).

January 19, 2019Open Access

Left Ventricular Torsion　― A New Echocardiographic Prognosticator in Patients With Non-Ischemic Dilated Cardiomyopathy ―

Q: What are the key findings of this study?

Reduced left ventricular torsion (<0.59 degrees/cm) significantly increased the risk of hospitalization for worsening heart failure compared to relatively preserved torsion (HR 6.41).

Q: What does this research mean for the field?

Reduced left ventricular torsion (<0.59 degrees/cm) significantly increases the risk of hospitalization for worsening heart failure in patients with non-ischemic dilated cardiomyopathy. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Reduced left ventricular torsion (<0.59 degrees/cm) significantly increased the risk of hospitalization for worsening heart failure compared to relatively preserved torsion (HR 6.41).

Study Design

Type

Observational (n=91)

Blinding

Double-blind

Multicenter

Structured PICO

Does reduced LV torsion predict hospitalization for worsening heart failure in patients with non-ischemic dilated cardiomyopathy?

Population

91 outpatients with newly diagnosed (<6 months) non-ischemic dilated cardiomyopathy (LVEF <50% in the absence of coronary disease, hypertensive heart disease, or congenital abnormalities), mean age 53±13 years, 20% female, in sinus rhythm, receiving optimal medical treatment. 43 healthy sex- and age-matched volunteers served as controls.

Intervention

Measurement of left ventricular (LV) torsion using 3D speckle-tracking echocardiography (stratified into relatively preserved >0.59 degrees/cm or reduced <0.59 degrees/cm)

Comparator

Relatively preserved LV torsion (>0.59 degrees/cm)

Outcome

Hospital admission for worsening heart failure within 12 months after enrollmenthard clinical

Reduced left ventricular torsion measured by 3D speckle-tracking echocardiography is a strong, independent predictor of hospitalization for worsening heart failure in patients with non-ischemic dilated cardiomyopathy.

Main Result

Effect estimate: HR 6.41 (95% CI 2.19-18.83)

Absolute Event Rate: 47% vs 7%

p-value: p=<0.001

Limitations

Observational nature of the study, which is hypothesis-generating
Limited number of events prevented adjustment in a fully multivariable model
Clinical outcome is age-dependent, which might limit generalizability
Exclusion of patients with significant mitral regurgitation
3D-STI is limited by its relative low temporal resolution

Abstract

BACKGROUND: Left ventricular (LV) torsion is a key parameter in cardiac function and predicts functional capacity (FC) more appropriately than LV ejection fraction (EF). We sought to investigate LV torsion as a marker of hospitalization for worsening heart failure (HF) in non-ischemic dilated cardiomyopathy (DCM) patients. METHODS AND RESULTS: (C-index: 0.85, P=0.02). CONCLUSIONS: The results demonstrated a clear relation between LV torsion and disease severity, suggesting that LV torsion has additional prognostic relevance in DCM patients.

Demander à l'IA

Bookmark

View Full Paper

Cite This Study

Rady et al. (Sat,) conducted a observational in Non-ischemic dilated cardiomyopathy (n=91). Reduced LV torsion (<0.59 degrees/cm) vs. Relatively preserved LV torsion (>0.59 degrees/cm) was evaluated on Hospital admission for worsening heart failure (HR 6.41, 95% CI 2.19-18.83, p=<0.001). Reduced left ventricular torsion (<0.59 degrees/cm) significantly increased the risk of hospitalization for worsening heart failure compared to relatively preserved torsion (HR 6.41).

synapsesocial.com/papers/6a1c076f0a1f7575939d6468 https://doi.org/https://doi.org/10.1253/circj.cj-18-0986