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Left ventricular ejection time is an independent predictor of incident heart failure in a community‐based cohort
Author(s) -
BieringSørensen Tor,
Querejeta Roca Gabriela,
Hegde Sheila M.,
Shah Amil M.,
Claggett Brian,
Mosley Thomas H.,
Butler Kenneth R.,
Solomon Scott D.
Publication year - 2018
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.928
Subject(s) - medicine , cardiology , heart failure , myocardial infarction , hazard ratio , cohort , blood pressure , framingham risk score , diastole , diabetes mellitus , ejection fraction , ventricular outflow tract , confidence interval , disease , endocrinology
Aims Systolic time intervals change in the progress of cardiac dysfunction. The usefulness of left ventricular ejection time ( LVET ) to predict cardiovascular morbidity, however, is unknown. Methods and results We studied middle‐aged African‐Americans from one of four cohorts of the Atherosclerosis Risk in Communities study (Jackson cohort, n =1980) who underwent echocardiography between 1993 and 1995. Left ventricular ejection time was measured by pulsed‐wave Doppler of the left ventricular outflow tract and related to outcomes. A shorter LVET was associated with younger age, male sex, higher diastolic blood pressure, higher proportion of diabetes, higher heart rate, higher blood glucose levels and worse fractional shortening. During a median follow‐up of 17.6 years, 384 (19%) had incident heart failure ( HF ), 158 (8%) had a myocardial infarction, and 587 (30%) died. In univariable analysis, a lower LVET was significantly associated with increased risk of all events ( P <0.05 for all). However, after multivariable adjustment for age, sex, hypertension, diabetes, body mass index, heart rate, systolic and diastolic blood pressure, fractional shortening and left atrial diameter, LVET remained an independent predictor only of incident HF [hazard ratio 1.07 (1.02–1.14), P =0.010 per 10 ms decrease]. In addition, LVET provided incremental prognostic information to the known risk factors included in the Framingham risk score, in regard to predicting all outcomes except for myocardial infarction. Conclusion Left ventricular ejection time is an independent predictor of incident HF in a community‐based cohort and provides incremental prognostic information on the risk of future HF and death when added to known risk prediction models.