Decreased right ventricular free wall and four-chamber longitudinal strain were associated with an increased risk of incident heart failure (HR 1.06, P=0.034 and HR 1.14, P=0.001, respectively).
Cohort (n=2,740)
Do right ventricular free wall and four-chamber longitudinal strain predict incident heart failure in the general population?
In the general population, reduced right ventricular longitudinal strain (RVFWLS and RV4CLS) is independently associated with a higher risk of incident heart failure, particularly among those with LVEF < 55%.
Effect estimate: HR 1.06 and HR 1.14 (95% CI 1.00-1.11 and 1.05-1.23)
p-value: p=0.034 and 0.001
AIMS: Right ventricular free wall (RVFWLS) and four-chamber longitudinal strain (RV4CLS) are associated with adverse events in various patient populations including patients with heart failure (HF). We sought to investigate the prognostic value of RVFWLS and RV4CLS for the development of incident HF in participants from the general population. METHODS AND RESULTS: Participants from the 5th Copenhagen City Heart Study (2011-2015) without known chronic ischaemic heart disease or HF at baseline were included. RVFWLS and RV4CLS were obtained using two-dimensional speckle-tracking echocardiography from the right ventricular (RV)-focused apical four-chamber view. The primary endpoint was incident HF. Among 2740 participants (mean age 54 ± 17 years, 42% male), 43 (1.6%) developed HF during a median follow-up of 5.5 years (IQR 4.5-6.3). Both RVFWLS and RV4CLS were associated with an increased risk of incident HF during follow-up independent of age, sex, hypertension, diabetes, body mass index and tricuspid annular plane systolic excursion (TAPSE), (HR 1.06, 95%CI 1.00-1.11, P = 0.034, per 1% absolute decrease and HR 1.14, 95%CI 1.05-1.23, P = 0.001, per 1% absolute decrease, respectively). Left ventricular ejection fraction (LVEF) modified the association between RV4CLS and incident HF (P for interaction = 0.016) such that RV4CLS was only of prognostic importance among those with LVEF < 55% (HR 1.21, 95%CI 1.11-1.33, P < 0.001 vs. HR 0.94, 95%CI 0.80-1.10, P = 0.43 in patients with LVEF ≥ 55%). CONCLUSION: In participants from the general population, both RVFWLS and RV4CLS were associated with a greater risk of incident HF independent of important baseline characteristics and TAPSE, and LVEF modified the relationship between RV4CLS and incident HF.
Espersen et al. (Wed,) conducted a cohort in General population without known chronic ischaemic heart disease or heart failure (n=2,740). Right ventricular free wall and four-chamber longitudinal strain was evaluated on Incident heart failure (HR 1.06 and HR 1.14, 95% CI 1.00-1.11 and 1.05-1.23, p=0.034 and 0.001). Decreased right ventricular free wall and four-chamber longitudinal strain were associated with an increased risk of incident heart failure (HR 1.06, P=0.034 and HR 1.14, P=0.001, respectively).