Cardiac Function and Sudden Cardiac Death in Heart Failure With Preserved Ejection Fraction (from the TOPCAT Trial)

Rajat Kalra, Kartik Gupta, Ryan Sheets, Sudeep Aryal, Ali Ebrahimi, Indranee Rajapreyar, Marc G. Cribbs, Oscar Julian Booker, Sumanth D. Prabhu, Navkaranbir S. Bajaj

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Patients with heart failure with preserved ejection fraction (HFpEF) have a significantly elevated risk of sudden cardiac death (SCD). However, few imaging data have been correlated to this risk. We evaluated the value of multiple echocardiographic markers of left ventricular (LV) function to predict SCD in HFpEF patients. The Treatment of Heart Failure with Preserved Ejection Fraction with Aldosterone Trial (TOPCAT)-Americas cohort was used to evaluate the echocardiographic predictors of SCD and/or aborted cardiac arrest (SCD/ACA). A retrospective cohort design was used. Cox proportional hazards and Poisson regression models were used to determine the associations between the risk of SCD/ACA and echocardiographic parameters: diastolic dysfunction grade, left ventricle ejection fraction, and LV global longitudinal strain (GLS) during follow-up. Impaired left ventricle ejection fraction and GLS were associated with SCD/ACA in univariate models (p = 0.007 and 0.002, respectively), but not diastolic function grade. After multivariate adjustment, only GLS remained a significant predictor of the incidence rate of SCD/ACA (p = 0.006). There was a 58% increase in the hazard of incident SCD/ACA for every 1 unit increase in GLS (1.58, 95%CI: 1.12 to 2.22, p = 0.009). These findings remained robust in the competing risk analyses. In conclusion, amongst the multiple echocardiographic parameters of LV function, GLS may help prognosticate the risk of SCD/ACA in HFpEF patients.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalAmerican Journal of Cardiology
Volume129
DOIs
StatePublished - Aug 15 2020

Bibliographical note

Funding Information:
This work was supported by the American College of Cardiology , Washington D.C., (Presidential Career Development award to NSB), the Walter B. Frommeyer, Junior Fellowship in Investigative Medicine, University of Alabama at Birmingham (to NSB), Birmingham, Alabama, National Center for Advancing Translational Research and National Heart Lung and Blood Institute, Bethesda, Maryland of the National Institutes of Health award number UL1TR001417 to NSB, R01HL147549-01, R01HL125735-01, R01HL128563-04, and T32HL129948-01 to SDP and Veterans Administration award number I01BX002706-01A1 to SDP. The content is solely the responsibility of the authors and does not necessarily represent the official views of the American College of Cardiology or National Institutes of Health or Veterans Administration.

Funding Information:
This manuscript was prepared using TOPCAT Research Materials obtained from the National Heart, Lung, and Blood Institute. None of the authors had any conflicts of interest or financial disclosures to declare. This work was supported by the American College of Cardiology, Washington D.C., (Presidential Career Development award to NSB), the Walter B. Frommeyer, Junior Fellowship in Investigative Medicine, University of Alabama at Birmingham (to NSB), Birmingham, Alabama, National Center for Advancing Translational Research and National Heart Lung and Blood Institute, Bethesda, Maryland of the National Institutes of Health award number UL1TR001417 to NSB, R01HL147549-01, R01HL125735-01, R01HL128563-04, and T32HL129948-01 to SDP and Veterans Administration award number I01BX002706-01A1 to SDP. The content is solely the responsibility of the authors and does not necessarily represent the official views of the American College of Cardiology or National Institutes of Health or Veterans Administration.

Publisher Copyright:
© 2020

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

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