Association of comorbidity burden with abnormal cardiac mechanics

Findings from the HyperGEN study

Senthil Selvaraj, Frank G. Aguilar, Eva E. Martinez, Lauren Beussink, Kwang Youn A Kim, Jie Peng, Laura Rasmussen-Torvik, Jin Sha, Marguerite R. Irvin, C. Charles Gu, Cora E. Lewis, Steven Hunt, Donna K. Arnett, Sanjiv J. Shah

Research output: Contribution to journalArticle

15 Citations (Scopus)

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 < 0.05 for all comparisons). 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.

Original languageEnglish
Article number000631
JournalJournal of the American Heart Association
Volume3
Issue number3
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Mechanics
Comorbidity
Heart Failure
Dyslipidemias
African Americans
Hypertension

Keywords

  • Cardiac mechanics
  • Comorbidities
  • Echocardiography
  • Risk factors
  • Strain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Selvaraj, S., Aguilar, F. G., Martinez, E. E., Beussink, L., Kim, K. Y. A., Peng, J., ... Shah, S. J. (2014). Association of comorbidity burden with abnormal cardiac mechanics: Findings from the HyperGEN study. Journal of the American Heart Association, 3(3), [000631]. https://doi.org/10.1161/JAHA.113.000631

Association of comorbidity burden with abnormal cardiac mechanics : Findings from the HyperGEN study. / Selvaraj, Senthil; Aguilar, Frank G.; Martinez, Eva E.; Beussink, Lauren; Kim, Kwang Youn A; Peng, Jie; Rasmussen-Torvik, Laura; Sha, Jin; Irvin, Marguerite R.; Charles Gu, C.; Lewis, Cora E.; Hunt, Steven; Arnett, Donna K.; Shah, Sanjiv J.

In: Journal of the American Heart Association, Vol. 3, No. 3, 000631, 2014.

Research output: Contribution to journalArticle

Selvaraj, S, Aguilar, FG, Martinez, EE, Beussink, L, Kim, KYA, Peng, J, Rasmussen-Torvik, L, Sha, J, Irvin, MR, Charles Gu, C, Lewis, CE, Hunt, S, Arnett, DK & Shah, SJ 2014, 'Association of comorbidity burden with abnormal cardiac mechanics: Findings from the HyperGEN study', Journal of the American Heart Association, vol. 3, no. 3, 000631. https://doi.org/10.1161/JAHA.113.000631
Selvaraj, Senthil ; Aguilar, Frank G. ; Martinez, Eva E. ; Beussink, Lauren ; Kim, Kwang Youn A ; Peng, Jie ; Rasmussen-Torvik, Laura ; Sha, Jin ; Irvin, Marguerite R. ; Charles Gu, C. ; Lewis, Cora E. ; Hunt, Steven ; Arnett, Donna K. ; Shah, Sanjiv J. / Association of comorbidity burden with abnormal cardiac mechanics : Findings from the HyperGEN study. In: Journal of the American Heart Association. 2014 ; Vol. 3, No. 3.
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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 < 0.05 for all comparisons). 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.",
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T1 - Association of comorbidity burden with abnormal cardiac mechanics

T2 - Findings from the HyperGEN study

AU - Selvaraj, Senthil

AU - Aguilar, Frank G.

AU - Martinez, Eva E.

AU - Beussink, Lauren

AU - Kim, Kwang Youn A

AU - Peng, Jie

AU - Rasmussen-Torvik, Laura

AU - Sha, Jin

AU - Irvin, Marguerite R.

AU - Charles Gu, C.

AU - Lewis, Cora E.

AU - Hunt, Steven

AU - Arnett, Donna K.

AU - Shah, Sanjiv J.

PY - 2014

Y1 - 2014

N2 - 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 < 0.05 for all comparisons). 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.

AB - 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 < 0.05 for all comparisons). 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.

KW - Cardiac mechanics

KW - Comorbidities

KW - Echocardiography

KW - Risk factors

KW - Strain

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