TY - JOUR
T1 - Association of comorbidity burden with abnormal cardiac mechanics
T2 - Findings from the HyperGEN study
AU - Selvaraj, Senthil
AU - Aguilar, Frank G.
AU - Martinez, Eva E.
AU - Beussink, Lauren
AU - Kim, Kwang Youn A.
AU - Peng, Jie
AU - Rasmussen-Torvik, Laura
AU - Sha, Jin
AU - Irvin, Marguerite R.
AU - Charles Gu, C.
AU - Lewis, Cora E.
AU - Hunt, Steven C.
AU - Arnett, Donna K.
AU - Shah, Sanjiv J.
N1 - Publisher Copyright:
© 2014 The Authors.
PY - 2014
Y1 - 2014
N2 - Background-Comorbidities are common in heart failure (HF), and the number of comorbidities has been associated with poor outcomes in HF patients. However, little is known about the effect of multiple comorbidities on cardiac mechanics, which could impact the pathogenesis of HF. We sought to determine the relationship between comorbidity burden and adverse cardiac mechanics. Methods and Results-We performed speckle-tracking analysis on echocardiograms from the HyperGEN study (n=2150). Global longitudinal, circumferential, and radial strain, and early diastolic (e') tissue velocities were measured. We evaluated the association between comorbidity number and cardiac mechanics using linear mixed effects models to account for relatedness among subjects. The mean age was 51±14 years, 58% were female, and 47% were African American. Dyslipidemia and hypertension were the most common comorbidities (61% and 58%, respectively). After adjusting for left ventricular (LV) mass index, ejection fraction, and several potential confounders, the number of comorbidities remained associated with all indices of cardiac mechanics except global circumferential strain (eg, β=-0.32 [95% CI -0.44, -0.20] per 1-unit increase in number of comorbidities for global longitudinal strain; β=-0.16 [95% CI -0.20, -0.11] for e' velocity; P=0.0001 for both comparisons). Results were similar after excluding participants with abnormal LV geometry (P < 0.05 for all comparisons). Conclusions-Higher comorbidity burden is associated with worse cardiac mechanics, even in the presence of normal LV geometry. The deleterious effect of multiple comorbidities on cardiac mechanics may explain both the high comorbidity burden and adverse outcomes in patients who ultimately develop HF.
AB - Background-Comorbidities are common in heart failure (HF), and the number of comorbidities has been associated with poor outcomes in HF patients. However, little is known about the effect of multiple comorbidities on cardiac mechanics, which could impact the pathogenesis of HF. We sought to determine the relationship between comorbidity burden and adverse cardiac mechanics. Methods and Results-We performed speckle-tracking analysis on echocardiograms from the HyperGEN study (n=2150). Global longitudinal, circumferential, and radial strain, and early diastolic (e') tissue velocities were measured. We evaluated the association between comorbidity number and cardiac mechanics using linear mixed effects models to account for relatedness among subjects. The mean age was 51±14 years, 58% were female, and 47% were African American. Dyslipidemia and hypertension were the most common comorbidities (61% and 58%, respectively). After adjusting for left ventricular (LV) mass index, ejection fraction, and several potential confounders, the number of comorbidities remained associated with all indices of cardiac mechanics except global circumferential strain (eg, β=-0.32 [95% CI -0.44, -0.20] per 1-unit increase in number of comorbidities for global longitudinal strain; β=-0.16 [95% CI -0.20, -0.11] for e' velocity; P=0.0001 for both comparisons). Results were similar after excluding participants with abnormal LV geometry (P < 0.05 for all comparisons). Conclusions-Higher comorbidity burden is associated with worse cardiac mechanics, even in the presence of normal LV geometry. The deleterious effect of multiple comorbidities on cardiac mechanics may explain both the high comorbidity burden and adverse outcomes in patients who ultimately develop HF.
KW - Cardiac mechanics
KW - Comorbidities
KW - Echocardiography
KW - Risk factors
KW - Strain
UR - http://www.scopus.com/inward/record.url?scp=84939460675&partnerID=8YFLogxK
U2 - 10.1161/JAHA.113.000631
DO - 10.1161/JAHA.113.000631
M3 - Article
C2 - 24780206
AN - SCOPUS:84939460675
SN - 2047-9980
VL - 3
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 3
M1 - 000631
ER -