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Prognostic implications of machine learning-derived echocardiographic phenotypes in community hypertensive patients.
- Source :
-
Clinical and experimental hypertension (New York, N.Y. : 1993) [Clin Exp Hypertens] 2023 Dec 31; Vol. 45 (1), pp. 2236334. - Publication Year :
- 2023
-
Abstract
- Background: Echocardiogram is commonly used to evaluate cardiac remodeling in hypertension (HTN). However, study on echocardiographic phenotypes and their prognostic implications in HTN is limited.<br />Objective: We aimed to evaluate the prognostic implications echocardiographic phenotypes in community hypertensive patients.<br />Method: A total of 1881 community hypertensive patients without overt cardiovascular disease and severe renal disease (mean age 62.8 years, women 57.9%) were included. Using Two-Step cluster analysis with four conventional echocardiographic variables, two clusters with distinct echocardiographic phenotypes were identified.<br />Result: The Cluster 1 (namely "mild-remodeling" HTN; n = 1492) had low prevalence of enlarged left atrium (LA; 0.9%) and left ventricular hypertrophy (LVH; 16.2%) and better LV diastolic function. They were younger and more likely to be men and had lower comorbid burden. The Cluster 2 (namely "severe-remodeling" HTN; n = 389) had higher prevalence of enlarged LA (26.0%) and LVH (83.0%) and worse LV diastolic function. They were older and more likely to be women and had higher comorbid burden. After a median follow-up of 4.2 years, compared to the Cluster 1, the Cluster 2 had higher incidence of cardiovascular (4.1% vs 1.7%; P = .006) and all-cause (9.8% vs 4.8%; P < .001) death, with adjusted hazard ratio of 2.80 (95% CI 1.39-5.62; P = .004) and 2.04 (95% CI 1.32-3.14; P < .001) respectively.<br />Conclusion: These findings indicate that the conventional echocardiographic variables-based algorithm could help identify asymptomatic community hypertensive patients at risk for cardiovascular and all-cause death. Further studies are needed to develop and validate phenotype-specific prevention and intervention strategies in HTN.
Details
- Language :
- English
- ISSN :
- 1525-6006
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Clinical and experimental hypertension (New York, N.Y. : 1993)
- Publication Type :
- Academic Journal
- Accession number :
- 37477238
- Full Text :
- https://doi.org/10.1080/10641963.2023.2236334