Any regional wall motion abnormality increased 5-year mortality from 17.5% to 29.7% in men and from 14.9% to 30.8% in women, with apical or inferior defects conveying the worst prognosis.
Cohort (n=492,338)
Yes
Does the presence of regional wall motion abnormalities on echocardiography increase long-term mortality in individuals undergoing echocardiography?
In a large national database, the presence of any regional wall motion abnormality on echocardiography significantly increased 5-year mortality, with inferoapical defects conveying the worst prognosis.
BACKGROUND: Regional wall motion abnormalities (WMAs) after myocardial infarction are associated with adverse remodeling and increased mortality in the short to medium term. Their long-term prognostic impact is less well understood. METHODS AND RESULTS: Via the National Echo Database of Australia (2000-2019), we identified normal wall motion versus WMA for each left ventricular wall among 492 338 individuals aged 61.9±17.9 years. The wall motion score index was also calculated. We then examined actual 1- and 5-year mortality, plus adjusted risk of long-term mortality according to WMA status. Overall, 39 346/255 697 men (15.4%) and 17 834/236 641 women (7.5%) had a WMA. The likelihood of a WMA was associated with increasing age and greater systolic/diastolic dysfunction. A defect in the inferior versus anterior wall was the most and least common WMA in men (8.0% and 2.5%) and women (3.3% and 1.1%), respectively. Any WMA increased 5-year mortality from 17.5% to 29.7% in men and from 14.9% to 30.8% in women. Known myocardial infarction (hazard ratio HR, 0.86 95% CI, 0.80-0.93) or revascularization (HR, 0.87 95% CI, 0.82-0.92) was independently associated with a better prognosis, whereas men (1.22-fold increase) and those with greater systolic/diastolic dysfunction had a worse prognosis. Among those with any WMA, apical (HR, 1.08 95% CI, 1.02-1.13) or inferior (HR, 1.09 95% CI, 1.04-1.15) akinesis, dyskinesis or aneurysm, or a wall motion score index >3.0 conveyed the worst prognosis. CONCLUSIONS: In a large real-world clinical cohort, twice as many men as women have a WMA, with inferior WMA the most common. Any WMA confers a poor prognosis, especially inferoapical akinesis/dyskinesis/aneurysm.
Playford et al. (Fri,) conducted a cohort in Regional wall motion abnormalities (n=492,338). Regional wall motion abnormalities vs. Normal wall motion was evaluated on 5-year mortality. Any regional wall motion abnormality increased 5-year mortality from 17.5% to 29.7% in men and from 14.9% to 30.8% in women, with apical or inferior defects conveying the worst prognosis.