Very low-flow state was significantly associated with increased all-cause mortality compared to normal flow state (HR 1.81; 95% CI 1.31-2.49; P=0.001).
Cohort (n=4,398)
Does a low left ventricular flow state increase the risk of all-cause and cardiovascular mortality in asymptomatic individuals without clinical cardiovascular disease?
In an asymptomatic population without clinical cardiovascular disease, a very low left ventricular flow state (SVi <30 ml/m2) assessed by CMR is an independent predictor of long-term all-cause mortality.
Hazard Ratio: 1.81 (95% CI 1.31–2.49)
p-value: p=0.001
Left ventricular (LV) flow state is associated with unfavorable outcome in patient with severe aortic stenosis. However, there is little information on its impact on long-term prognosis in a population without valvular disease. To examine the impact of LFS on all-cause mortality in multi-ethnic population we analyzed 4398 asymptomatic participants without clinical cardiovascular disease undergoing cardiac magnetic resonance (CMR) in the Multi-Ethnic Study of Atherosclerosis. LV stroke volume index (SVi), LVEF and myocardial contraction fraction (MCF) were measured. LV flow states were classified as normal flow state (NFS, SVi >35 ml/m 2 ), low-flow state (LFS, 30-34 ml/m 2 ) and very low-flow state (VLFS: SVi <30 ml/m 2 ). Clinical data were collected at enrollment. Participants were followed up for a median of 14.2 years. All-cause and cardiovascular disease mortalities were used as primary endpoints. All-cause mortality was 16.2% and cardiovascular disease mortality 3.5%. VLFS and LFS groups had more cardiovascular risk factors and lower cardiac performance than NFS. The relationship between all-cause mortality and SVi was “L-shape with the “breakpoint” at 33.5ml/m2 for a statistical significance (p=0.009). All-cause mortality was significantly associated with LFS after adjusted for age, sex, LVEF, and LV mass index with hazard ratio (HR) 1.81, 95% CI: 1.31-2.49 for VLF and HR: 1.21, 95% CI: 0.95-1.54 for LFS with overall p value 0.001). The highest cardiovascular disease mortality was seen in VLFS.
Yuan et al. (Mon,) conducted a cohort in Asymptomatic without clinical cardiovascular disease (n=4,398). Very low-flow state (VLFS) and low-flow state (LFS) vs. Normal flow state (NFS) was evaluated on All-cause and cardiovascular disease mortalities (HR 1.81, 95% CI 1.31-2.49, p=0.001). Very low-flow state was significantly associated with increased all-cause mortality compared to normal flow state (HR 1.81; 95% CI 1.31-2.49; P=0.001).
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