scholarly journals Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study

2018 ◽  
Vol 20 (5) ◽  
pp. 533-540 ◽  
Author(s):  
Chike C Nwabuo ◽  
Henrique T Moreira ◽  
Henrique D Vasconcellos ◽  
Nathan Mewton ◽  
Anders Opdahl ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Global Function ◽  
Function Index ◽  
Incident Heart Failure

scholarly journals Left Ventricular Global Function Index and Left Ventricular Mass Volume Ratio By CMR: Relation with Heart Failure in Thalassemia Major Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2688-2688
Author(s):  
Antonella Meloni ◽  
Lucia De Franceschi ◽  
Domenico Maddaloni ◽  
Sabrina Carollo ◽  
Roberto Sarli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Overload ◽  
Volume Ratio ◽  
Thalassemia Major ◽  
Left Ventricular ◽  
Myocardial Iron ◽  
Global Function ◽  
Function Index ◽  
Lv Mass ◽  
Mass Volume

Abstract Introduction: Recently two novels indicators of left ventricular (LV) performance assessed by Cardiovascular Magnetic Resonance (CMR) have been introduced: the LV global function index (LVGFI) and the LV mass/volume ratio (LVMVR). The LVGFI combines LV stroke volume, end-systolic and end diastolic volumes, as well as LV mass, integrating structural as well as mechanical behaviour. Elevated LVMVR is indicative of concentric remodelling. A LVGFI <37% and a LVMVR>1 were shown to be associated with the occurrence of cardiovascular events in no-thalassemic populations. This retrospective cohort study aimed to systematically evaluate in a large historical cohort of thalassemia major (TM) in the CMR era whether the LVGFI and the LVMVR were associated with a higher risk of heart failure. Methods: We considered 812 TM patients (391 M, 30.4±8.6 years), consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) network. LVGFI and LVMRI were quantitatively evaluated by SSFP cine images. The T2* value in all the 16 cardiac segments was evaluated and a global heart T2* value <20 ms was considered indicative of myocardial iron overload (MIO). Results: Eighty (9.9%) patients had a LVGFI<37% and, compared to the patients with a normal LVGFI, they showed a significant higher frequency of heart failure (43.8% vs 4.2%; P<0.0001). Patients with a LVGFI<37% had a significant higher risk of heart failure (odds-ratio-OR=17.59, 95%CI=9.95-21.09; P=<0.001). The risk remained significant also adjusting for the presence of MIO (OR=15.54, 95%CI=8.05-26.27; P=<0.001). Thirty (3.7%) patients had a LVMVR≥1% and, compared to the patients with a normal LVMRI, they showed a significant higher frequency of heart failure (20.0% vs 7.7%; P=0.015). Patients with a LVMVR≥1% had a significant higher risk of heart failure (OR=3.01, 95%CI=1.18-7.64; P=0.021). The risk remained significant also adjusting for the presence of MIO (OR=3.44, 95%CI=1.31-9.01; P=0.012). In a multivariate model including LVGFI, LVMVR and heart iron, the significant predictors of heart failure were a LVGFI<37% (OR=14.05, 95%CI=7.66-25.77; P=<0.001) and a global heart T2*<20 ms (OR=1.94, 95%CI=1.08-3.47; P=0.026). Conclusions: In TM patients a LVGFI<37% was associated with an higher risk of heart failure, independent by the presence of MIO. A widespread program using CMR exploiting its multi-parametric potential can have considerable power for the early identification and treatment of patients at risk for heart failure. Disclosures No relevant conflicts of interest to declare.

scholarly journals Left ventricular global function index: prognostic value in patients with heart failure aged 60 years and older

2020 ◽  
Vol 19 (5) ◽  
pp. 2404
Author(s):  
V. N. Larina ◽  
V. I. Lunev ◽  
M. N. Alekhin
Keyword(s):  
Heart Failure ◽  
Prognostic Value ◽  
Mass Density ◽  
Nyha Class ◽  
Class Ii ◽  
Left Ventricular ◽  
Class Iii ◽  
Global Function ◽  
Lower Survival ◽  
Function Index

Left ventricular (LV) global function index (LVGFI) is a novel marker that incorporates the functional and structural characteristics of the LV.Aim. To evaluate the prognostic value of LVGFI in outpatients with heart failure with preserved ejection fraction (HFpEF) aged 60 years and older.Material and methods. The study included 78 patients (male, 42%) aged 74 (67-77) years with NYHA class II-III heart failure. LVGFI was defined as LV stroke volume/LV global volume х 100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/ density).Results. The median LVGFI was 21,7% (interquartile range 19,3 to 22,9%). Higher NYHA class of HF was associated with worse LVGFI:class II HF was associated with LVGFI of 22,0 (20,3-23,1)%, class III HF — with 20,4 (17,5-22,4)%. During the 3—month (24-48) follow-up period, 15 (19,2%) patients died. Among patients with NYHA class II HF, 6 out of 61 (9,8%) died, with class III HF — 9 out of 17 (53,0%) (p<0,001). According to ROC analysis, the optimal LVGFI cut-off point for the prediction of an unfavorable prognosis in patients with HFpEF aged 60 years was ≤21,1% (p<0,001). The sensitivity was 73,3%, specificity — 70,0%. Patients with LVGFI ≤21,1% had significantly lower survival: among patients with LVGFI ≤21,1%, 11 out of 30 (36,7%) died; among those with LVGFI >21,1%, 4 out of 48 (8,3 %) died (p=0,016).Conclusion. Higher NYHA class of HF was associated with worse LVGFI. Patients with lower LVGFI have significantly lower survival. The optimal LVGFI cut-off point for the prediction of an unfavorable prognosis in patients with HFrEF aged 60 years was <21,1%.

scholarly journals The odyssey to dethrone LV ejection fraction continues: the prognostic value of LV global function index in heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Rocha ◽  
G Cunha ◽  
J.A Sousa ◽  
S Maltes ◽  
P Freitas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Primary Endpoint ◽  
Volume Ratio ◽  
Left Ventricular ◽  
Volume Index ◽  
Prognostic Information ◽  
Global Function ◽  
Function Index ◽  
Lv Ejection Fraction

Abstract Background Left Ventricular (LV) Global Function index (LVGFi) is a parameter that combines data from global systolic performance and volumetric anatomical information, measurable by non-contrast Cardiac Magnetic Resonance (CMR). We aimed to evaluate whether LVGFi predicts major cardiovascular outcomes and outperforms LV ejection fraction (LVEF) in Heart Failure (HF). Methods We conducted a retrospective single-centre study of consecutive patients with HF who were referred to and had a LVEF &lt;50% at CMR. Other than inadequate images for endocardial or epicardial border delineation, there were no exclusion criteria. LVEF was determined by 3D measurement. LVGFi was calculated as the LV stroke volume to the LV global volume ratio (Figure 1). The primary endpoint was a composite of time to all-cause death or HF hospitalization. Results The cohort was comprised of 433 HF patients (mean age 64±12 years, 74.1% male, ischaemic HF 53.1%, NYHA I-II 83.9%) with a mean LVEF of 33.5±10.0% and LVGFi of 22.8±7.4%. Over a median follow-up of 27 (17–37) months, 85 (19.6%) met the primary endpoint and 42 (9.7%) died. Patients with an event of the primary endpoint had markers of more severe HF, as noted by a reduced functional capacity (NYHA I-II: 63.5 vs. 89.0%; p&lt;0.001) and increased natriuretic peptides [NT-proBNP: 2664 (1022–27242) vs. 791 (337–7258); p&lt;0.001). Likewise, CMR showed higher LV volumes (e.g., LV end-diastolic volume index: 137±50 vs. 120±43mL/m2; p=0.001) and reduced LV performance indices, namely LVEF (29.2±10.6 vs 34.5±9.6%; p&lt;0.001) and LVGFi (19.8±7.4 vs 23.6±7.3%; p&lt;0.001). Both LVEF and LVGFi independently predicted the primary endpoint in multivariate analysis (separately imputed into a model adjusted for NYHA, NT-proBNP and creatinine). The LVEF model was more powerful than that of LVGFi. Similarly, LVGFi did not provide incremental prognostic information over LVEF in c-statistics analysis (0.653 vs. 0.622; p=0.645) (Figure 2). Conclusion While LVGFi independently predicted major outcomes in patients with HF and LVEF &lt;50%, it did not surpass LVEF. Our findings contrast to those demonstrating LVGFi as a powerful variable that outperforms LVEF in hypertrophic cardiomyopathy, cardiac amyloidosis, and healthy subjects at risk of developing structural heart disease. We hypothesize that LVGFi might be primarily useful in the prognostic stratification of patients with preserved LVEF. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

Abstract 16614: Left Ventricular Global Function Index (A Novel Marker of Cardiac Performance) Predicts Incident Cardiovascular Events: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chike C Nwabuo ◽  
Nathan Mewton ◽  
Anders Opdahl ◽  
Henrique T Moreira ◽  
Kofo Ogunyankin ◽  
...  
Keyword(s):  
Young Adults ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Predictive Value ◽  
Cardiac Performance ◽  
Global Function ◽  
Function Index ◽  
Lv Mass ◽  
Lv Ejection Fraction

Introduction: Left ventricle (LV) function is typically evaluated independent of LV structure and vice versa. LV global function index (LVGFI) is a novel marker of cardiac performance that accounts for LV structural alterations and has been previously validated using magnetic resonance imaging. Hypothesis: We evaluated the prognostic utility of LVGFI assessed by echocardiography for incident cardiovascular disease (CVD) and heart failure (HF) events in comparison to LV ejection fraction (LVEF) and LV mass Methods: Included were 4107 Coronary Artery Risk Development in Young Adults (CARDIA) study participants with available m-mode echocardiographic parameters in 1990-1991 (Year-5). LV volumes were obtained using the Teichholz formula. LVGFI defined as LV stroke volume/LV global volume* 100, where LV global volume was calculated as the sum of the LV mean cavity volume (LVEDV + LVESV)/2) and myocardium volume (LV mass/density). Median follow-up time was 21.9 years. Cox regression models, adjusted for risk factors, were utilized to predict the endpoints of HF, hard CVD and all CVD events. Results: Mean age of participants at Year-5 was 29.8 ± 3.7 years, 55% were female, 51.3% white and mean LVGFI was 34.7 ± 6.2%. A total of 174 incident CVD events were observed during the 21.9 years median follow-up. In multivariable adjusted models, 1-SD increase in LVGFI was significantly associated with lower hazard of HF, Hazard Ratio (HR) =0.55 95% confidence interval (CI) [0.40 - 0.74]; hard CVD, HR=0.74 95% CI [0.63 - 0.88] and all CVD events, HR=0.76 95% CI [0.65 -0.88]. (Table 1). LVGFI provided incremental predictive value for incident CVD compared to LV mass and LV ejection fraction alone.(Figure 1). Conclusions: LVGFI in early adulthood was associated with incident HF, hard CVD and all CVD events. In this longitudinal community study, LVGFI provided robust, independent and incremental predictive value for incident CVD events.

scholarly journals Association of Lipoprotein (a) variants with risk of cardiovascular disease: a Mendelian randomization study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Xia ◽  
Chunyue Guo ◽  
Kuo Liu ◽  
Yunyi Xie ◽  
Han Cao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Chinese Population ◽  
Left Ventricular Mass Index ◽  
Mendelian Randomization ◽  
Left Ventricular ◽  
Han Chinese ◽  
Han Chinese Population ◽  
Internal Dimension

Abstract Background There is a well-documented empirical relationship between lipoprotein (a) [Lp(a)] and cardiovascular disease (CVD); however, causal evidence, especially from the Chinese population, is lacking. Therefore, this study aims to estimate the causal association between variants in genes affecting Lp(a) concentrations and CVD in people of Han Chinese ethnicity. Methods Two-sample Mendelian randomization analysis was used to assess the causal effect of Lp(a) concentrations on the risk of CVD. Summary statistics for Lp(a) variants were obtained from 1256 individuals in the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei. Data on associations between single-nucleotide polymorphisms (SNPs) and CVD were obtained from recently published genome-wide association studies. Results Thirteen SNPs associated with Lp(a) levels in the Han Chinese population were used as instrumental variables. Genetically elevated Lp(a) was inversely associated with the risk of atrial fibrillation [odds ratio (OR), 0.94; 95% confidence interval (95%CI), 0.901–0.987; P = 0.012)], the risk of arrhythmia (OR, 0.96; 95%CI, 0.941–0.990; P = 0.005), the left ventricular mass index (OR, 0.97; 95%CI, 0.949–1.000; P = 0.048), and the left ventricular internal dimension in diastole (OR, 0.97; 95%CI, 0.950–0.997; P = 0.028) according to the inverse-variance weighted method. No significant association was observed for congestive heart failure (OR, 0.99; 95% CI, 0.950–1.038; P = 0.766), ischemic stroke (OR, 1.01; 95%CI, 0.981–1.046; P = 0.422), and left ventricular internal dimension in systole (OR, 0.98; 95%CI, 0.960–1.009; P = 0.214). Conclusions This study provided evidence that genetically elevated Lp(a) was inversely associated with atrial fibrillation, arrhythmia, the left ventricular mass index and the left ventricular internal dimension in diastole, but not with congestive heart failure, ischemic stroke, and the left ventricular internal dimension in systole in the Han Chinese population. Further research is needed to identify the mechanism underlying these results and determine whether genetically elevated Lp(a) increases the risk of coronary heart disease or other CVD subtypes.

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