Abstract 9893: The Associations Between Layer-Specific Global Circumferential Strain Parameters and Incident Heart Failure: The Copenhagen City Heart Study

Abstract

Introduction: Global circumferential strain (GCS) has been demonstrated to be sensitive marker of early cardiac pathology compared to conventional echocardiographic measurements. Improvement in speckle tracking echocardiography has introduced layer-specific quantification of GCS. This study investigated the differences in the prognostic value of endomyocardial (GCS Endo ) and epimyocardial (GCS Epi ) GCS regarding incident HF (heart failure) in the general population. Methods: The prospective cohort study included randomly invited individuals from the general population. All participants were examined with echocardiography. Exclusion criteria were prevalent HF at baseline, non-sinus rhythm during echocardiography and inadequate image quality for speckle tracking analysis. Cox proportional hazard regression models were utilized to assess associations between GCS Endo and GCS Epi with incident HF. A multivariable model was created, which included left ventricular (LV) ejection fraction, LV mass index, and the variables from the ARIC HF risk score. Results: A total of 2874 individuals were included in the study sample. Mean age was 53 years ± 18 years and 40% were males. Mean GCS Endo and GCS Epi were 31.9 ± 5.3% and 14.3 ± 4.0% respectively. During a follow-up period of 5.4 years (IQR: 4.5; 6.3) 52 suffered incident HF. The cumulative incidence of HF according to the medians of layer-specific GCS is illustrated in Figure 1. In multivariable Cox regressions, GCS Endo remained significantly associated with HF (HR = 1.06 95%CI: [1.00; 1.12], per 1 % decrease), while GCS Epi did not (HR = 1.01 95%CI: [0.94; 1.10], per 1 % decrease). The same pattern was observed when only adjusting for age and sex. Additionally, GCS Endo provided significantly higher Harrel’s C-statistics as compared to GCS Epi (0.68 95%CI[0.58; 0.77] vs 0.60 95%CI[0.50; 0.69]). Conclusions: In the general population, GCS Endo is independently associated with incident HF while GCS Epi is not.