Association of Echocardiographic Parameter E/e’ With Cardiovascular Events in a Diverse Population of Inpatients and Outpatients With and Without Cardiac Diseases and Risk Factors - 02/03/23
, Shang-Hung Chang, MD, PhD a, b, e, hAbstract |
Background |
The echocardiographic parameter E/e’ has been associated with cardiovascular (CV) events. However, few studies have analyzed multiple associated CV outcomes using E/e’ in a diverse population of both inpatients and outpatients with and without cardiac diseases and risk factors.
Methods |
Medical records of 75,393 patients without atrial fibrillation (AF) with first available E/e’ were retrieved from our hospital database. Patients with mitral valve disease were excluded, and the remainder were studied in protocol 1 (70,819 patients). Patients with hypertension, diabetes mellitus, hyperlipidemia, CV diseases, prior CV events, CV surgeries, and left ventricular ejection fraction <50% or missing left ventricular ejection fraction were further excluded, and the remaining patients were studied in protocol 2 (14,665 patients). The study outcomes are major adverse CV events (MACE), which included myocardial infarction (MI), AF, ischemic and hemorrhagic stroke (IHS), hospitalization for heart failure (HHF), and cardiac death. The primary outcomes were MACE and each of the MACE components.
Results |
At the end of maximal 5-year follow-up (median 22.18 months with interquartile range 7.20-49.08 months for MACE in protocol 1 and 23.46 months with interquartile range 8.15-49.02 months for MACE in protocol 2), compared with an E/e’ value of <8, an intermediate value of E/e’ 8 to 15 and a high value of E/e’ >15 were significantly associated with MACE, MI, AF, IHS, HHF, and cardiac death in protocol 1 (all P < .0001). In protocol 2, an intermediate E/e’ value of 8 to 15 and a high value of E/e’ >15 were significantly associated with MACE, MI, AF, IHS, HHF, and CV death (all P < .05), except an intermediate value E/e’ 8 to 15 was not associated with AF.
Conclusions |
In a diverse population of inpatients and outpatients with and without cardiac diseases and risk factors, the echocardiographic parameter E/e’ was associated with CV events and is a useful marker of risk.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Previously, E/e’ was studied in specific diseases for CV events. |
• | E/e’ was analyzed for association with CV events in inpatients and outpatients. |
• | E/e’ is a useful marker for CV events, AF, and cardiac death. |
Keywords : Echocardiography, E/e’, Cardiovascular events, Atrial fibrillation, Cardiac death
Abbreviations : AF, aHR, ANOVA, CGRD, COPD, CV, eGFR, HHF, HIS, HR, ICD, ICD-9-CM, IQR, LAVi, LDL-C, LV, LVEF, MACE, MI
Plan
| Drs. Huang and Chang contributed equally to this work. |
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| Conflicts of Interest: None. |
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| This study received support from the Maintenance Project of the Center for Big Data Analytics and Statistics Grant CLRPG3D0047 at Chang Gung Memorial Hospital. |
Vol 36 - N° 3
P. 284-294 - mars 2023 Retour au numéro
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