Key result
Increasing isovolumic relaxation time over a decade increased the risk of subsequent heart failure in participants aged <65 years (per 10 ms increase: HR 1.33; 95% CI 1.02-1.72; p=0.034).
Why the study?
Whether cardiac time intervals change over time, which clinical factors accelerate these changes, and whether such changes associate with incident heart failure remain unknown.
Are changes in cardiac time intervals over a decade associated with incident heart failure in the general population?
Cohort (n=1,064)
Are changes in cardiac time intervals over a decade associated with incident heart failure in the general population?
An increase in isovolumic relaxation time over a decade is associated with an increased risk of subsequent heart failure in individuals under 65 years of age.
Answers are grounded in this paper and cite their sources.
IVRT changes may flag higher HF risk under age 65; hypothesis-generating and should not yet alter practice.
BACKGROUND: The cardiac time intervals include the isovolumic contraction time (IVCT), the left ventricular ejection time (LVET), the isovolumic relaxation time (IVRT) and the combination of all the cardiac time intervals in the myocardial performance index (MPI) (defined as [(IVCT+IVRT)/LVET)]. Whether the cardiac time intervals change over time and which clinical factors that accelerate these changes is not well-established. Additionally, whether these changes are associated with subsequent heart failure (HF), remains unknown. METHODS: We investigated participants from the general population (n = 1064) who had an echocardiographic examination including color tissue Doppler imaging performed in both the 4th and 5th Copenhagen City Heart Study. The examinations were performed 10.5 years apart. RESULTS: The IVCT, LVET, IVRT and MPI increased significantly over time. None of the investigated clinical factors were associated with increase in IVCT. Systolic blood pressure (standardized β= - 0.09) and male sex (standardized β= - 0.08) were associated with an accelerated decrease in LVET. Age (standardized β=0.26), male sex (standardized β=0.06), diastolic blood pressure (standardized β=0.08), and smoking (standardized β=0.08) were associated with an increase in IVRT, while HbA1c (standardized β= - 0.06) was associated with a decrease in IVRT. Increasing IVRT over a decade was associated with an increased risk of subsequent HF in participants aged <65 years (per 10 ms increase: HR 1.33; 95%CI (1.02-1.72), p = 0.034). CONCLUSION: The cardiac time increased significantly over time. Several clinical factors accelerated these changes. An increase in IVRT was associated with an increased risk of subsequent HF in participants aged <65 years.
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Alhakak et al. (2023) conducted a cohort in Heart failure (n=1,064). Increase in isovolumic relaxation time (IVRT) was evaluated on Subsequent heart failure in participants aged <65 years (HR 1.33, 95% CI 1.02-1.72, p=0.034). Increasing isovolumic relaxation time over a decade increased the risk of subsequent heart failure in participants aged <65 years (per 10 ms increase: HR 1.33; 95% CI 1.02-1.72; p=0.034).
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