Abstract 14401: Elevated Levels of Angiotensin II Type 1 Receptor Autoantibodies Are Associated With Abnormal Echocardiogram Parameters in Women With Preeclampsia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Anum S Minhas ◽  
Sammy Zakaria ◽  
Monica Mukherjee ◽  
Theresa Boyer ◽  
Neal Fedarko ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Lv Remodeling ◽  
Echocardiographic Parameters ◽  
Prospective Longitudinal

Introduction: Preeclampsia (PEC) increases the long-term risk for heart failure with preserved ejection fraction (HFpEF). While the underlying pathogenesis is unknown, angiotensin II type 1 receptor autoantibodies (AT1-AA) have been implicated. AT1-AA bind agonistically to the AT1 receptor and may result in clinical manifestations of preeclampsia. We aimed to determine whether women with PEC have elevated AT1-AA levels compared to normotensive women (controls) during pregnancy and at 4 years postpartum, and whether AT1-AA levels correlate with abnormal echocardiographic parameters. Methods: We performed a prospective longitudinal cohort study comparing women with PEC (n=21) to controls (n=20). AT1-AA and echocardiographic measurements were obtained during pregnancy and 4 years postpartum. Linear regression analyses were performed to evaluate the association between AT1-AA levels and important echocardiographic parameters. Results: Mean AT1-AA level during pregnancy differed significantly between women with PEC versus healthy pregnant controls (10.21±3.20 vs 6.33±3.40 μg/ml, p<0.001). Women with PEC were more likely to be black and deliver at an earlier gestational age. Higher AT1-AA was associated with increased systolic/diastolic blood pressure, echocardiographic markers of biventricular systolic function (tricuspid annular systolic plane excursion and left ventricular (LV) ejection fraction), concentric LV hypertrophy and worsened diastolic function. AT1-AA remained persistently elevated at 4 years in women with PEC at baseline compared to controls (12.76±5.13 vs 4.47±1.49 μg/ml, p<0.001) (Figure 1). Conclusions: Women with PEC have elevated AT1-AA compared to controls, both during pregnancy and 4 years postpartum. Higher AT1-AA is associated with abnormal diastolic parameters, LV remodeling, and hyperdynamic biventricular function. These findings suggest that AT1-AA plays an important role in the risk of HFpEF in PEC.

scholarly journals Prospective longitudinal characterisation of the relationship between diabetes and cardiac remodeling

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
A Chowdhary ◽  
N Jex ◽  
S Thirunavukarasu ◽  
T Craven ◽  
A Das ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ejection Fraction ◽  
Event Rate ◽  
Systolic Function ◽  
Major Adverse Cardiovascular Event ◽  
Left Ventricular ◽  
Adverse Cardiovascular Event ◽  
Prospective Longitudinal ◽  
Over Time

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Clinical Research Training Fellowship and Wellcome Trust Background Cardiovascular disease represents the primary cause of death in patients with type 2 diabetes (T2D). Heart failure (HF) is the commonest initial presentation of cardiovascular disease in T2D. Development of HF in patients with T2D is associated with a 4 to 6-fold increase in mortality, making the prevention of cardiac dysfunction an important goal. The long-term impact of T2D on cardiac function in the absence of cardiovascular disease is unknown. This is the first prospective longitudinal study utilising cardiovascular magnetic resonance (CMR) to evaluate the impact of T2D on cardiac remodeling. Objectives To determine longitudinal changes in the phenotypic expression of heart disease in diabetes over 6 years, and examine the association of baseline blood and imaging biomarkers with remodeling over time in patients who remained free of cardiovascular/clinical events, and to report clinical outcomes in the entire cohort. Methods 100 asymptomatic T2D patients with no history of cardiovascular disease or hypertension were previously studied. Biventricular volumes, function, and myocardial strain were assessed by CMR and blood biomarkers taken. 6-year follow-up CMR was repeated in those without interim cardiovascular events. Results Of the 100 patients, 78 could be contacted for follow-up. 29 participants experienced cardiovascular/clinical events over 6 years. 32 patients who were asymptomatic and without events received follow-up CMR. The major adverse cardiovascular event rate (MI, angina, revascularisation, stroke, death) during the 6-year follow-up period, including the patients with a silent MI, amounted to 25% in this study with an overall clinical event rate of 35%.  There were no significant changes in BP, BMI or HBA1c between baseline and follow-up (Table 1). Left ventricular end-diastolic-volume(p = 0.005), mass (p = 0.01), ejection fraction (p = 0.0001), and right ventricular end-diastolic-volume(p = 0.03) and ejection fraction(p = 0.003) reduced over time (Figure 2 and Table 1). Baseline plasma high-sensitivity cardiac-troponin-T (hs-cTnT) (R=-0.44; p = 0.01) was significantly associated with change in left ventricular ejection fraction over time. Conclusions Even in the absence of overt clinical CAD, significant valvular disease, uncontrolled hypertension or change in BMI, T2D results in significant reductions in cardiac size and biventricular systolic function over time. The major adverse cardiovascular event rate (MI, angina, revascularisation, stroke, death) during the 6-year follow-up period was high in diabetes patients (25%). Plasma biomarker hs-cTnT measured at baseline was associated with change in LV systolic function over the 6-year follow-up period. hs-cTnT could potentially have a significant utility as a risk-predicting tool for cardiac dysfunction in T2D patients.

scholarly journals 114 Impact of left ventricular ejection fraction on procedural and long-term outcomes of bifurcation percutaneous coronary intervention

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Guglielmo Gallone ◽  
Francesc Bruno ◽  
Ovidio De Filippo ◽  
Enrico Cerrato ◽  
Saverio Muscoli ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality ◽  
The Impact

Abstract Aims Longitudinal systolic function may integrate information on aortic stenosis (AS) natural history and cardiac comorbidities with potential prognostic implications. We explored the impact of tissue Doppler imaging (TDI)-derived longitudinal systolic function defined by the peak systolic average of lateral and septal mitral annular velocities (average S’) among symptomatic patients with severe AS undergoing transcatheter aortic valve implantation (TAVI). Methods and results 297 unselected patients with severe AS undergoing TAVI from January 2017 to December 2018 at three European centres, with available average S′ at preprocedural echocardiography were retrospectively included. The primary endpoint was the Kaplan Meier estimate of all-cause mortality. After a median 18 months (IQR 12–18) follow-up, 36 (12.1%) patients died. Average S′ was associated with all-cause mortality (per 1 cm/s decrease: HR: 1.29, 95% CI: 1.03–1.60, P = 0.025), with a best cut-off of 6.5 cm/s. Patients with average S′ &lt;6.5 cm/s (55.2% of the study population) presented characteristics of more advanced left ventricular remodelling and functional impairment along with higher burden of cardiac comorbidities, and experienced higher all-cause mortality (17.6% vs. 7.5%, P = 0.007) also when adjusted for in-study outcome predictors (adj-HR: 3.33, 95% CI: 1.25–8.90, P = 0.016). Results were consistent among patients with preserved ejection fraction, normal-flow AS, high-gradient AS and in those without left ventricular hypertrophy. Conclusions Longitudinal systolic function assessed by average S’ is independently associated with long-term all-cause mortality among unselected patients with symptomatic severe AS undergoing TAVI. In this population, an average S′ below 6.5 cm/s best defines clinically meaningful reduced longitudinal systolic function and may aid clinical risk stratification.

scholarly journals Non-invasive intraventricular pressure differences estimated with cardiac MRI in subjects without heart failure and with heart failure with reduced and preserved ejection fraction

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001088 ◽  
Author(s):  
Francisco Londono-Hoyos ◽  
Patrick Segers ◽  
Zeba Hashmath ◽  
Garrett Oldland ◽  
Maheshwara Reddy Koppula ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Spatiotemporal Pattern ◽  
Intraventricular Pressure ◽  
Preserved Ejection Fraction ◽  
Non Invasive ◽  
Echocardiographic Parameters

ObjectiveNon-invasive assessment of left ventricular (LV) diastolic and systolic function is important to better understand physiological abnormalities in heart failure (HF). The spatiotemporal pattern of LV blood flow velocities during systole and diastole can be used to estimate intraventricular pressure differences (IVPDs). We aimed to demonstrate the feasibility of an MRI-based method to calculate systolic and diastolic IVPDs in subjects without heart failure (No-HF), and with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).MethodsWe studied 159 subjects without HF, 47 subjects with HFrEF and 32 subjects with HFpEF. Diastolic and systolic intraventricular flow was measured using two-dimensional in-plane phase-contrast MRI. The Euler equation was solved to compute IVPDs in diastole (mitral base to apex) and systole (apex to LV outflow tract).ResultsSubjects with HFpEF demonstrated a higher magnitude of the early diastolic reversal of IVPDs (−1.30 mm Hg) compared with the No-HF group (−0.78 mm Hg) and the HFrEF group (−0.75 mm Hg; analysis of variance p=0.01). These differences persisted after adjustment for clinical variables, Doppler-echocardiographic parameters of diastolic filling and measures of LV structure (No-HF=−0.72; HFrEF=−0.87; HFpEF=−1.52 mm Hg; p=0.006). No significant differences in systolic IVPDs were found in adjusted models. IVPD parameters demonstrated only weak correlations with standard Doppler-echocardiographic parameters.ConclusionsOur findings suggest distinct patterns of systolic and diastolic IVPDs in HFpEF and HFrEF, implying differences in the nature of diastolic dysfunction between the HF subtypes.

scholarly journals Cardioprotective Effects of Qishenyiqi Mediated by Angiotensin II Type 1 Receptor Blockade and Enhancing Angiotensin-Converting Enzyme 2

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Yong Wang ◽  
Chun Li ◽  
Yulin Ouyang ◽  
Junda Yu ◽  
Shuzhen Guo ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Ejection Fraction ◽  
Ace Inhibitor ◽  
Left Ventricular ◽  
Myocardial Tissue ◽  
Receptor Blockade ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Cardioprotective Effects

The aim of this paper was to investigate whether the effects of QSYQ on CHD are associated with the renin-angiotensin-aldosterone system (RAAS). The formula groups were lavaged with QSYQ, using fosinopril sodium as a control. The level of RAAS components in the myocardial tissue was measured, respectively. The results showed that both QSYQ and fosinopril sodium can improve the ejection fraction in CHD and that QSYQ decreases the left ventricular end-systolic diameter and left ventricular end-diastolic diameter, while fosinopril sodium has no effects on these parameters. Fosinopril sodium, as an ACE inhibitor, downregulated ACE expression and eventually reduced the tissue AngII concentration but had no effect on ACE2. Moreover, it had no effect on renin or AT2, while QSYQ significantly decreased the level of renin and expression of AngII in myocardial tissue. The results also revealed that QSYQ can act on both AT1 and AT2, thus, blocking the effect of AngII and increasing the level of ACE2. It also downregulated the levels of TGF-βand MMP-9, but it had no effect on ACE. This study showed that the ameliorative effects of QSYQ on CHD in rats had multiple targets associated with the inhibition of RAAS, thus, producing cardioprotective therapy effects.

Abstract 13409: Left Ventricular Remodeling and Function Following Aortic Valve Replacement for Low-Flow, Low-Gradient Aortic Stenosis With Preserved Ejection Fraction-Results From the TOPAS Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Abdellaziz Dahou ◽  
Marie-Annick Clavel ◽  
Jean G Dumesnil ◽  
Romain Capoulade ◽  
Henrique B Ribeiro ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Ejection Fraction ◽  
Aortic Valve Replacement ◽  
Stroke Volume ◽  
Systolic Function ◽  
Left Ventricular ◽  
Low Flow ◽  
Lv Remodeling ◽  
And Function

Background: Aortic valve replacement (AVR) is recommended (IIa) in symptomatic patients with paradoxical low-flow, low-gradient aortic stenosis (PLF-LG AS). This entity is characterized by pronounced LV concentric remodeling with impaired LV filling and reduced LV longitudinal systolic function and stroke volume despite preserved LV ejection fraction (p-EF). However, there is lack of data about the evolution of LV geometry and function following AVR in these patients. Methods: We prospectively enrolled thirty-two patients (age=71±12 years; 59% men) with PLF-LG AS (SVi<35 mL/m2, mean gradient<40 mmHg, indexed aortic valve area [AVA] 50%) who underwent AVR within 3 months following inclusion. Stroke volume was measured in the LV outflow tract by pulsed-wave Doppler and indexed for body surface area (SVi). Global left ventricular longitudinal strain (GLS) was measured by 2D speckle tracking. Results: Following AVR, mean gradient decreased (15±8 mmHg post vs. 30±7 pre AVR) and AVA increased significantly (1.40±0.31 vs. 0.70±0.12 cm2) (all p<0.0001). AVR was associated with a positive LV remodeling with an increase in LV end-diastolic diameter (46±4 vs. 44±4 vs mm; p=0.0027) and volume (99±21 vs. 89±20 ml, p=0.003) and a decrease in relative wall thickness (0.46±0.06 vs. 0.58±0.11; p=0.0004) and LV mass (175±37 vs. 207±44 g; p=0.002). SVi increased significantly from baseline to 1 year (36±7 vs. 31±3 ml/m2; p=0.0002), whereas LVEF remained unchanged (63±6 vs 63±7; p=NS). SVi increased significantly in the subset of patients with mild to moderate DD at baseline (all p<0.05) but not in those with severe DD (p=NS). GLS also increased significantly from baseline to 1 year (17±4 vs. 14.5±4%; p=0.03). There was a significant correlation between post-AVR increase in GLS and increase in SVi (r=0.52; p=0.02). Conclusion: The findings of this study demonstrate that in patients with PLF-LG AS and p-EF, AVR is associated with an increase in LV stroke volume which is mainly due to positive LV remodeling and improvement in LV longitudinal systolic function. Our results provide further support to the ACC/AHA recommendations with regard to indication of AVR in these patients.

scholarly journals 571 Echo-Omics to estimate prognosis after an acute myocardial infarction: which one to pic?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D De Campos ◽  
C Saleiro ◽  
R Teixeira ◽  
A Botelho ◽  
J Lopes ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Septal Thickness ◽  
All Cause Mortality ◽  
Echocardiographic Parameters ◽  
One Year

Abstract BACKGROUND Simple and reproducible echocardiographic parameters are still the cornerstone of daily clinical practice. These data provides important information for the evaluation of patients with ST-segment elevation myocardial infarction (STEMI). The identification of prognostic echocardiographic parameters in STEMI would help in risk stratification. PURPOSE To evaluate the discriminatory capacity of echocardiographic parameters after a STEMI. METHODS Single centre retrospective observational study of 303 patients with STEMI who survived hospital stay and had a complete echocardiographic evaluation. The following ecocardiographic parameters were collected at discharge: left ventricular (LV) systolic and diastolic volumes; septal and posterior wall thickness; LV ejection fraction (LVEF); left atrial (LA) diameter; estimated systolic pulmonary artery pressure (SPAP). One year and long-term all cause mortality were analyzed. RESULTS For the patients enrolled (71% males, 64.6 ± 14.1 years old), peak troponin I was 99.1 ± 126.5 ng/mL; mean GRACE score was 153.6 ± 38.8 points and mean LVEF was 46.2 ± 11.2%. One year mortality was 8.3% and during a median 73 months follow-up, 25.1% patients were deceased. After adjustment for echocardiographic variables in a Cox regression model, SPAP (HR 1.07, 95%CI 1.02-1.12, P = 0.007) and septal thickness (HR 1.36, 95%CI 1.08-1.73, P = 0.01) were both independently associated with one year mortality. A Kaplan-Meier survival methodology using stratified SPAP and septal thickness showed a trend of different event rate (log rank P = 0.003 and P = 0.035, respectively), with a gradation of cumulative risk for all-cause mortality, with a sharp increase at &gt;40mmHg and &gt;11mm, respectively. Regarding longterm follow-up, only increased SPAP proved to be an independent predictor of mortality (HR 1.04, 95%CI 1.01-1.08, P = 0.016). The difference in favor of an SPAP &lt;33mmHg (sensitivity 86.67% and specificity 54.1%) was seen early after the STEMI event and maintained at each interim analysis (log rank P = 0.002). Upon the visual analysis of the cubic spline curves, patients with SPAP &lt; ± 30mmHg had a good long-term survival. No association of LV volumes or LVEF was noted for both one year and long-term mortality. CONCLUSION Classic echocardiographic parameters still have a role to estimate prognosis after STEMI. Estimated SPAP had the greatest discriminatory capabilities, surpassing left ventricular ejection fraction! Abstract 571 FIGURE 1

A Review of Angiotensin Receptor Blocker-based Therapies at all Levels of Cardiovascular Risk

2011 ◽  
Vol 7 (4) ◽  
pp. 254 ◽  
Author(s):  
Giuliano Tocci ◽  
Lorenzo Castello ◽  
Massimo Volpe ◽  
◽  
◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Ventricular Hypertrophy ◽  
Renin Angiotensin System ◽  
Left Ventricular ◽  
Clinical Settings ◽  
Angiotensin Ii Receptor ◽  
Angiotensin System ◽  
Receptor Blockers ◽  
Artery Disease

The renin–angiotensin system (RAS) has a key role in the maintenance of cardiovascular homeostasis, and water and electrolyte metabolism in healthy subjects, as well as in several diseases including hypertension, left ventricular hypertrophy and dysfunction, coronary artery disease, renal disease and congestive heart failure. These conditions are all characterised by abnormal production and activity of angiotensin II, which represents the final effector of the RAS. Over the last few decades, accumulating evidence has demonstrated that antihypertensive therapy based on angiotensin II receptor blockers (ARBs) has a major role in the selective antagonism of the main pathological activities of angiotensin II. Significant efforts have been made to demonstrate that blocking the angiotensin II receptor type 1 (AT1) subtype receptors through ARB-based therapy results in proven benefits in different clinical settings. In this review, we discuss the main benefits of antihypertensive strategies based on ARBs in terms of their efficacy, safety and tolerability.

ACCESSMENT OF RIGHT VENTRICULAR SYSTOLIC FUNCTION USING TAPSE

2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).

Prognostic value of global longitudinal layer specific strain for patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Johnsen ◽  
M Sengeloev ◽  
P Joergensen ◽  
N Bruun ◽  
D Modin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Funding Source ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Abstract Background Novel echocardiographic software allows for layer-specific evaluation of myocardial deformation by 2-dimensional speckle tracking echocardiography. Endocardial, epicardial- and whole wall global longitudinal strain (GLS) may be superior to conventional echocardiographic parameters in predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). Purpose The purpose of this study was to investigate the prognostic value of endocardial-, epicardial- and whole wall GLS in patients with HFrEF in relation to all-cause mortality. Methods We included and analyzed transthoracic echocardiographic examinations from 1,015 patients with HFrEF. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained. A p value in a 2-sided test &lt;0.05 was considered statistically significant. Cox proportional hazards regression models were constructed, and both univariable and multivariable hazard ratios (HRs) were calculated. Results During a median follow-up time of 40 months, 171 patients (16.8%) died. A lower endocardial (HR 1.17; 95% CI (1.11–1.23), per 1% decrease, p&lt;0.001), epicardial (HR 1.20; 95% CI (1.13–1.27), per 1% decrease, p&lt;0.001), and whole wall (HR 1.20; 95% CI (1.14–1.27), per 1% decrease, p&lt;0.001) GLS were all associated with higher risk of death (Figure 1). Both endocardial (HR 1.12; 95% CI (1.01–1.23), p=0.027), epicardial (HR 1.13; 95% CI (1.01–1.26), p=0.040) and whole wall (HR 1.13; 95% CI (1.01–1.27), p=0.030) GLS remained independent predictors of mortality in the multivariable models after adjusting for significant clinical parameters (age, sex, total cholesterol, mean arterial pressure, heart rate, ischemic cardiomyopathy, percutaneous transluminal coronary angioplasty and diabetes) and conventional echocardiographic parameters (left ventricular (LV) ejection fraction, LV mass index, left atrial volume index, deceleration time, E/e', E-velocity, E/A ratio and tricuspid annular plane systolic excursion). No other echocardiographic parameters remained an independent predictors after adjusting. Furthermore, endocardial, epicardial and whole wall GLS had the highest C-statistics of all the echocardiographic parameters. Conclusion Endocardial, epicardial and whole wall GLS are independent predictors of all-cause mortality in patients with HFrEF. Furthermore, endocardial, epicardial and whole wall GLS were superior prognosticators of all-cause mortality compared with all other echocardiographic parameters. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Herlev and Gentofte Hospital

Sign in / Sign up

Export Citation Format

Share Document