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Association of Comorbidity Burden With Abnormal Cardiac Mechanics: Findings From the HyperGEN Study
- Source :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
- Publication Year :
- 2014
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2014.
-
Abstract
- Background Comorbidities are common in heart failure ( HF ), and the number of comorbidities has been associated with poor outcomes in HF patients. However, little is known about the effect of multiple comorbidities on cardiac mechanics, which could impact the pathogenesis of HF . We sought to determine the relationship between comorbidity burden and adverse cardiac mechanics. Methods and Results We performed speckle‐tracking analysis on echocardiograms from the HyperGEN study (n=2150). Global longitudinal, circumferential, and radial strain, and early diastolic (e') tissue velocities were measured. We evaluated the association between comorbidity number and cardiac mechanics using linear mixed effects models to account for relatedness among subjects. The mean age was 51±14 years, 58% were female, and 47% were African American. Dyslipidemia and hypertension were the most common comorbidities (61% and 58%, respectively). After adjusting for left ventricular ( LV ) mass index, ejection fraction, and several potential confounders, the number of comorbidities remained associated with all indices of cardiac mechanics except global circumferential strain (eg, β=−0.32 [95% CI −0.44, −0.20] per 1‐unit increase in number of comorbidities for global longitudinal strain; β=−0.16 [95% CI −0.20, −0.11] for e' velocity; P ≤0.0001 for both comparisons). Results were similar after excluding participants with abnormal LV geometry ( P Conclusions Higher comorbidity burden is associated with worse cardiac mechanics, even in the presence of normal LV geometry. The deleterious effect of multiple comorbidities on cardiac mechanics may explain both the high comorbidity burden and adverse outcomes in patients who ultimately develop HF .
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Heart Ventricles
Comorbidity
comorbidities
White People
cardiac mechanics
strain
Risk Factors
Internal medicine
Image Interpretation, Computer-Assisted
medicine
Humans
echocardiography
Circumferential strain
Mass index
Dyslipidemias
Original Research
Heart Failure
Ejection fraction
business.industry
Confounding
Heart
Stroke Volume
Middle Aged
medicine.disease
Echocardiography, Doppler
Black or African American
Cross-Sectional Studies
Heart failure
Hypertension
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Cardiac mechanics
Dyslipidemia
Subjects
Details
- ISSN :
- 20479980
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of the American Heart Association
- Accession number :
- edsair.doi.dedup.....3fdc0847c80699b7a4b825f6cf0b6fd3