Abstract
The identification of predictors of major cardiovascular events (MACES) represents a big challenge, especially in early and stable cardiovascular diseases. This prospective study comparatively evaluated the prognostic importance of left ventricular (LV) and right ventricular (RV) systolic and diastolic function, pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) in a stable patient’s cohort with cardiovascular risk factors. The LV ejection fraction, mitral annular plane systolic excursion (MAPSE), tricuspid annular plane systolic excursion (TAPSE), functional mitral regurgitation (FMR), doppler tissue imaging of mitral and tricuspid annulus with systolic and diastolic peaks estimation, tricuspid regurgitation velocity (TRV), pulmonary velocity outflow time integral (PVTI), mean pulmonary artery pressure (MPAP) and PVR were estimated at enrollment. During the follow-up, MACES and all-cause mortality were recorded. 369 subjects with or without previous MACES were enrolled. Bivariate analysis revealed LVEF, TAPSE, MPAP, TRV, PVR, LV diastolic function, and FMR were associated with the endpoints. When computing the influence of covariates to the primary endpoint (all-cause mortality and MACES) through Cox analysis, only LV diastolic function and TAPSE entered the final model; for the secondary endpoint (MACES) only TAPSE entered. TAPSE was able to predict MACES and all-cause mortality in early and stable cardiovascular diseases. The use of TAPSE should be implemented.
Highlights
Many clinical variables and ultrasound parameters play a prognostic role in advanced or unstable cardiovascular diseases [1]
A few commonly used echocardiographic parameter expression of left ventricular (LV) systolic and diastolic function, functional mitral regurgitation (FMR), and right ventricular (RV) function play a prognostic role in overall population and in stable patients with previous major cardiovascular events (MACES) [3,4,5,6]
The study was approved by the Ethics Committee of Modena and written informed consent was obtained from participants before the enrollment
Summary
Many clinical variables and ultrasound parameters play a prognostic role in advanced or unstable cardiovascular diseases [1]. A few commonly used echocardiographic parameter expression of left ventricular (LV) systolic and diastolic function, functional mitral regurgitation (FMR), and right ventricular (RV) function play a prognostic role in overall population and in stable patients with previous MACES [3,4,5,6]. To our knowledge, in stable patients with cardiovascular risk factors a comparative study has not been conducted yet This prospective, observational cohort study was designed to ascertain the prognostic value of old and new ultrasound parameters of LV and RV systolic and diastolic function (principally derived from mitral and tricuspid annular motion), FMR, pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) in stable patients with cardiovascular risk factors with or without previous MACES
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