Background
Methods
Patient population
Cardiovascular magnetic resonance and EF1
Transthoracic echocardiography and EF1
Statistical analysis
Results
Patient characteristics and major events
Characteristic | Overall N = 141 | CMR EF1 ≤ 20%N = 741 | CMR EF1 > 20%N = 671 | p-value2 |
---|---|---|---|---|
Age | 70 (63, 75) | 70 (64, 75) | 69 (62, 75) | 0.5 |
Sex | 0.5 | |||
Female | 44 (31%) | 25 (34%) | 19 (28%) | |
Male | 97 (69%) | 49 (66%) | 48 (72%) | |
Hypertension | 94 (67%) | 51 (69%) | 43 (64%) | 0.6 |
Dyslipidaemia | 66 (47%) | 36 (49%) | 30 (45%) | 0.6 |
Diabetes | 22 (16%) | 9 (12%) | 13 (19%) | 0.2 |
Coronary artery disease | 53 (38%) | 30 (41%) | 23 (34%) | 0.4 |
Systolic BP (mmHg) | 147 (133, 162) | 145 (132, 162) | 148 (137, 163) | 0.5 |
Diastolic BP (mmHg) | 83 (76, 92) | 84 (77, 92) | 82 (76, 92) | 0.5 |
NYHA class | < 0.001 | |||
I | 66 (47%) | 22 (30%) | 44 (66%) | |
II | 45 (32%) | 26 (35%) | 19 (28%) | |
III | 27 (19%) | 23 (31%) | 4 (6%) | |
IV | 3 (2%) | 3 (4%) | 0 (0%) | |
AV Vmax (m/s) | 3.8 (3.3, 4.4) | 4.2 (3.8, 4.7) | 3.4 (2.7, 3.8) | < 0.001 |
AV MPG (mmHg) | 33 (22, 43) | 41 (32, 48) | 24 (15, 33) | < 0.001 |
AVA (cm2) | 0.87 (0.73, 1.08) | 0.78 (0.66, 0.91) | 1.04 (0.81, 1.31) | < 0.001 |
Zva (mmHg/mL/m2) | 4.01 (3.26, 4.47) | 4.11 (3.39, 4.78) | 3.91 (3.25, 4.23) | 0.035 |
LVMI (g/m2) | 87 (73, 101) | 90 (74, 103) | 86 (72, 96) | 0.15 |
SVI (ml/m2) | 47 (41, 55) | 48 (41, 56) | 47 (40, 53) | 0.6 |
CMR EF (%) | 67 (64, 71) | 67 (63, 71) | 67 (64, 71) | 0.5 |
CMR EF1 (%) | 19 (14, 23) | 14 (9, 17) | 24 (22, 26) | < 0.001 |
TTE EF1 (%) (n = 126) | 25 (18, 30) | 20 (12, 28) | 27 (25, 30) | < 0.001 |
CMR GLS (%) | − 18.0 (− 20.1, − 15.9) | − 17.7 (− 19.3, − 15.3) | − 18.6 (− 20.5, − 16.1) | 0.082 |
Native T1 (ms) | 1179 (1155, 1206) | 1190 (1162, 1216) | 1171 (1153, 1195) | 0.046 |
ECV fraction (%) | 27.6 (25.7, 29.7) | 27.7 (25.7, 29.8) | 27.4 (25.8, 29.1) | 0.4 |
iECV (ml/m2) | 22 (18, 27) | 23 (19, 29) | 22 (18, 26) | 0.10 |
Infarct LGE | 21 (15%) | 11 (15%) | 10 (15%) | > 0.9 |
Non-infarct LGE | 40 (28%) | 23 (31%) | 17 (25%) | 0.5 |
hs-cTnI (ng/L) | 7 (4, 12) | 8 (4, 15) | 5 (3, 10) | 0.055 |
BNP (ng/L) | 26 (11, 54) | 29 (14, 71) | 19 (9, 50) | 0.13 |
Comparison of CMR EF1 and TTE EF1
CMR EF1 and other clinical characteristics
Coefficient | 95% CI | r2 | |
---|---|---|---|
Age per 10 years | − 0.08 | − 0.18, 0.02 | 0.02 |
Male sex | 0.01 | − 0.24, 0.26 | 0.00 |
Hypertension | − 0.15 | − 0.39, 0.10 | 0.01 |
Ejection fraction (log2) | 0.43 | − 0.33, 1.19 | 0.01 |
Mean gradient (log2) | − 0.47*** | − 0.60, − 0.33 | 0.26 |
Left ventricular mass index (log2) | − 0.25 | − 0.59, 0.08 | 0.02 |
Valvuloarterial compliance (log2) | − 0.36* | − 0.68, − 0.03 | 0.03 |
Native T1 (log2) | − 1.23 | − 3.52, 1.05 | 0.01 |
Extracellular volume fraction (log2) | 0.21 | − 0.66, 1.08 | 0.00 |
Indexed extracellular volume (log2) | − 0.17 | − 0.46, 0.12 | 0.01 |
Late gadolinium enhancement (any) | − 0.05 | − 0.29, 0.19 | 0.00 |
Infarct late gadolinium enhancement (any) | − 0.12 | − 0.44, 0.21 | 0.00 |
Global longitudinal strain (log2) | − 0.12 | − 0.37, 0.12 | 0.01 |
High− sensitivity cardiac troponin I (log2) | − 0.05 | − 0.13, 0.02 | 0.01 |
Brain natriuretic peptide (log2) | − 0.05 | − 0.12, 0.01 | 0.02 |
Model 1 (r2 0.06) n = 137 | Model 2 (r2 0.07) n = 117 | Model 3 (r2 0.07) n = 117 | |||||||
---|---|---|---|---|---|---|---|---|---|
Coefficient | 95% CI | p value | Coefficient | 95% CI | p value | Coefficient | 95% CI | p value | |
Zva | − 0.44 | − 0.79, − 0.09 | < 0.05 | − 0.35 | − 0.73, 0.04 | ns | − 0.32 | − 0.71, 0.08 | ns |
iECV | − 0.26 | − 0.57, 0.04 | ns | − 0.31 | − 0.69, 0.07 | ns | − 0.34 | − 0.74, 0.05 | ns |
Infarct LGE | − 0.01 | − 0.32, 0.32 | ns | − 0.05 | − 0.39, 0.29 | ns | − 0.07 | − 0.42, 0.28 | ns |
Hs-cTnI | 0.01 | − 0.10, 0.11 | ns | 0.01 | − 0.09, 0.12 | ns | |||
BNP | − 0.02 | − 0.11, 0.07 | ns | − 0.01 | − 0.10, 0.09 | ns | |||
Age per 10 years | − 0.03 | − 0.14, 0.09 | ns | ||||||
Male | 0.06 | − 0.20, 0.33 | ns |
Prediction of events by CMR EF1
HR | CI (95%) | P | HR | CI (95%) | P | HR | CI (95%) | P | ||
---|---|---|---|---|---|---|---|---|---|---|
Univariate | Multivariate CMR EF1 | Multivariate TTE EF1 | ||||||||
Age | 1.01 | 0.99, 1.03 | 0.25 | 1.01 | 0.82, 1.23 | > 0.9 | 1.01 | 0.82, 1.24 | > 0.9 | |
Male | 1.30 | 0.70, 2.40 | 0.41 | 1.59 | 0.93, 2.74 | 0.091 | 1.20 | 0.70, 2.04 | 0.5 | |
NYHA | ||||||||||
II | 1.19 | 0.77, 1.83 | 0.43 | 0.95 | 0.54, 1.66 | 0.9 | 1.06 | 0.60, 1.86 | 0.9 | |
III/IV | 3.43 | 2.16, 5.47 | < 0.001 | 2.41 | 1.29, 4.51 | 0.006 | 3.01 | 1.56, 5.82 | 0.001 | |
MPG | 1.05 | 1.04, 1.06 | < 0.001 | 1.06 | 1.04, 1.08 | < 0.001 | 1.07 | 1.04, 1.09 | < 0.001 | |
CMR EF1 | 0.89 | 0.86, 0.92 | < 0.001 | 0.93 | 0.89, 0.97 | 0.001 | - | - | - | |
TTE EF1 | 0.88 | 0.85, 0.91 | < 0.001 | - | - | - | 0.89 | 0.86, 0.93 | < 0.001 | |
Infarct LGE | 0.54 | 0.32, 0.91 | 0.02 | 1.06 | 0.58, 1.94 | 0.8 | 0.55 | 0.29, 1.05 | 0.068 | |
iECV | 1.06 | 1.03, 1.09 | < 0.001 | 0.99 | 0.95, 1.02 | 0.5 | 0.99 | 0.96, 1.03 | 0.6 |