Background
Methods
Study population
Echocardiographic measurements
Assessment of LV geometry and function
Assessment of valvular and arterial disease
SEAS study endpoints
Statistical analyses
Results
Characteristics of patients with high global LV load
Total study population (N=1418) | Normal global LV load (N=1166) | High global LV load (N=252) | P value | |
---|---|---|---|---|
Age (yrs) | 67±10 | 67±10 | 70±9 | <0.001 |
Female gender (%) | 39 | 37 | 45 | 0.015 |
Systolic blood pressure (mmHg) | 145±20 | 146±20 | 155±21 | <0.001 |
Diastolic blood pressure (mmHg) | 83±10 | 82±10 | 86±10 | <0.001 |
Body mass index (kg/m2) | 26.9±4.3 | 26.7±4.2 | 27.4±4.5 | 0.053 |
Mean blood pressure (mmHg) | 104±11 | 104±11 | 109±12 | <0.001 |
Pulse pressure (mmHg) | 65±18 | 64±18 | 70±19 | <0.001 |
Hypertension (%) | 83 | 81 | 93 | <0.001 |
Heart rate (bmp) | 66±11 | 65±11 | 68±12 | 0.001 |
Antihypertensive treatment (%) | 57 | 55 | 60 | 0.078 |
Angiotensin Converting Enzyme Inhibitor (%) | 15 | 15 | 15 | 0.933 |
Angiotensin Receptor Blocker (%) | 11 | 11 | 10 | 0.737 |
Calcium Antagonist (%) | 17 | 16 | 19 | 0.213 |
Beta Blocker (%) | 28 | 27 | 32 | 0.126 |
Alpha Blocker | 2 | 2 | 4 | 0.006 |
LV mass index (g/m2.7) | 46.2±14.9 | 46.0±14.8 | 45.5±14.0 | 0.659 |
LV hypertrophy (%) | 37 | 37 | 36 | <0.001 |
Relative wall thickness (%) | 0.36±0.09 | 0.36±0.08 | 0.36±0.10 | 0.769 |
Normal LV geometry (%) | 57 | 55 | 57 | 0.658 |
Ejection fraction (%) | 66±7 | 67±6 | 66±7 | 0.014 |
Low ejection fraction (%) | 1 | 1 | 3 | 0.064 |
Mitral regurgitation | ||||
Grade 1 (%) | 38 | 39 | 37 | 0.567 |
Grade 2(%) | 10 | 9 | 13 | 0.089 |
Grade 3 (%) | 1 | 1 | 1 | 0.418 |
Aortic regurgitation | ||||
Grade 1 (%) | 43 | 43 | 45 | 0.550 |
Grade 2(%) | 16 | 17 | 13 | 0.109 |
Grade 3 (%) | 1 | 1 | 1 | 0.604 |
Aortic annulus (cm) | 2.19±0.26 | 2.24±0.26 | 1.98±0.20 | <0.001 |
Sinotubular aortic diameter (cm) | 2.81±0.44 | 2.83±0.44 | 2.73±0.42 | <0.001 |
Ascending aorta diameter (cm) | 3.92±0.58 | 3.93±0.58 | 3.88±0.54 | 0.250 |
Peak aortic jet velocity (m/s) | 3.08±0.54 | 3.07±0.53 | 3.13±0.56 | 0.131 |
Aortic valve area (cm2) | 1.27±0.45 | 1.37±0.45 | 0.86±0.25 | <0.001 |
Energy loss index | 0.90±0.47 | 0.98±0.47 | 0.55±0.20 | <0.001 |
Mean transaortic gradient (mmHg) | 23±9 | 22±9 | 24±9 | 0.026 |
Systemic arterial compliance | 0.71±0.29 | 0.83±0.33 | 0.43±0.10 | <0.001 |
Zva (mm Hg/ml · m2) | 4.13±1.35 | 3.50±0.80 | 5.91±0.92 | NA |
Total cholesterol (mmol/L) | 5.73±1.02 | 5.70±1.03 | 5.86±0.96 | 0.024 |
Serum creatinine (mmol/L) | 93±16 | 93±15 | 95±17 | 0.283 |
Doppler Stroke volume (ml) | 85±25 | 91±24 | 58±10 | <0.001 |
LV end-diastolic volume, by biplane Simpson (ml) | 76±25 | 76±25 | 79±25 | 0.125 |
LV end-systolic volume, by biplane Simpson (ml) | 43±22 | 42±22 | 47±24 | 0.022 |
Cardiac output by Doppler(L/min) | 5.5±1.8 | 5.9±1.7 | 3.9±1.0 | 0.757 |
Cardiac index (L/min/m2) | 2.9±0.9 | 3.1±09 | 2.1±0.5 | 0.629 |
Beta | T | P value | |
---|---|---|---|
Constant | 18.78 | <0.001 | |
Age (years) | 0.04 | 2.08 | 0.037 |
Hypertension | 0.157 | 7.67 | <0.001 |
Female gender | 0.10 | 4.82 | <0.001 |
Ejection fraction (%) | −0.05 | −2.63 | 0.009 |
Aortic valve area (m2) | −0.67 | −31.76 | <0.001 |
Global LV load and prognosis
Type of events | Patients with normal global LV load (N=1166) | Patients with high global LV load (N=252) | P value |
---|---|---|---|
Major CV events | 368(32%) | 108 (43%) | 0.001 |
Aortic valve events | 340 (29%) | 104 (41%) | <0.001 |
Ischemic CV events | 180 (15%) | 46 (18%) | 0.268 |
Total mortality | 96 (8%) | 36 (14%) | 0.003 |
Primary model | Secondary model § | |||
---|---|---|---|---|
HR (95% CI) ‡ | P | HR (95% CI) § | P | |
Major CV events | 1.49 (1.19-1.86) | <0.001 | 1.35 (1.08-1.69) | 0.010 |
Aortic valve events | 1.55 (1.23-1.95) | <0.001 | 1.41(1.12-1.78) | 0.004 |
Ischemic CV events | 0.99 (0.71-1.39) | 0.962 | 0.91 (0.65-1.28) | 0.589 |
Total Mortality | 1.36 (0.91-2.02) | 0.138 | 1.29 (0.86-1.95) | 0.215 |