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Publications (10 of 396) Show all publications
Ismaili, J., Ibrahimi, P., Berisha-Muharremi, V., Karahoda, R., Berbatovci-Ukimeraj, M., Istrefi, N., . . . Bajraktari, G. (2025). Predictors of subclinical atherosclerosis in asymptomatic healthy non-diabetic postmenopausal women. Clinical Physiology and Functional Imaging, 45(1), Article ID e12920.
Open this publication in new window or tab >>Predictors of subclinical atherosclerosis in asymptomatic healthy non-diabetic postmenopausal women
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2025 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 45, no 1, article id e12920Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIM: Cardiovascular disease progresses after menopause. Conventional risk factors, particularly diabetes, for atherosclerosis are well-established predictors of phenotypic arterial disease. The aim of this study is to assess the predictors of subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women.

METHODS: This prospective study included 117 consecutive postmenopausal women (mean age 59 ± 7 years) referred from the outpatient Rheumatology Clinic of the University Clinical Centre of Kosovo, recruited between September 2021 and December 2022. Clinical, biochemical, carotid ultrasound and coronary CT angiography data were analysed. Subclinical atherosclerosis was diagnosed when plaque and/or carotid intima-media thickness >1.00 mm were present.

RESULTS: Women who had subclinical atherosclerosis had higher erythrocyte sedimentation (p = 0.022), higher total cholesterol (p = 0.013), higher CAC score (p = 0.017), and higher prevalence of CAC > 100 HU and CAC > 400 HU (p = 0.017 and p = 0.034, respectively) compared to those without subclinical atherosclerosis. Women who had mild coronary calcification (CAC score ≥10 HU) were older (p = 0.005), in longer menopause (p = 0.005), had thicker CIMT (p = 0.008) with higher prevalence (p = 0.03) compared to those with CAC score <10 HU. Women with moderate coronary calcification (CAC score ≥100 HU) had higher triglycerides, worse CIMT (p = 0.005) with higher prevalence (p = 0.039) compared to those with CAC score <100 HU. In multivariate analysis [odds ratio 95% confidence interval], age [1.101 (1.032-1.174), p = 0.037] and cholesterol [2.020 (1.225-3.331), p = 0.006] independently predicted the presence of subclinical atherosclerosis.

CONCLUSIONS: In addition to the impact of age, hypercholesterolaemia is an important predictor of subclinical atherosclerosis in non-diabetic postmenopausal women.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
atherosclerosis, carotid ultrasound, coronary calcification, menopause, women
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-233847 (URN)10.1111/cpf.12920 (DOI)001379600300001 ()39688094 (PubMedID)2-s2.0-85212907157 (Scopus ID)
Available from: 2025-01-09 Created: 2025-01-09 Last updated: 2025-02-10Bibliographically approved
Campora, A., Lisi, M., Pastore, M. C., Mandoli, G. E., Ferrari Chen, Y. F., Pasquini, A., . . . Cameli, M. (2024). Atrial fibrillation, atrial myopathy, and thromboembolism: the additive value of echocardiography and possible new horizons for risk stratification. Journal of Clinical Medicine, 13(13), Article ID 3921.
Open this publication in new window or tab >>Atrial fibrillation, atrial myopathy, and thromboembolism: the additive value of echocardiography and possible new horizons for risk stratification
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2024 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, no 13, article id 3921Article, review/survey (Refereed) Published
Abstract [en]

Atrial fibrillation (AF) is the most common cardiac sustained arrhythmia, and it is associated with increased stroke and dementia risk. While the established paradigm attributes these complications to blood stasis within the atria and subsequent thrombus formation with cerebral embolization, recent evidence suggests that atrial myopathy (AM) may play a key role. AM is characterized by structural and functional abnormalities of the atria, and can occur with or without AF. Moving beyond classifications based solely on episode duration, the 4S-AF characterization has offered a more comprehensive approach, incorporating patient’s stroke risk, symptom severity, AF burden, and substrate assessment (including AM) for tailored treatment decisions. The “ABC” pathway emphasizes anticoagulation, symptom control, and cardiovascular risk modification and emerging evidence suggests broader benefits of early rhythm control strategies, potentially reducing stroke and dementia risk and improving clinical outcomes. However, a better integration of AM assessment into the current framework holds promise for further personalizing AF management and optimizing patient outcomes. This review explores the emerging concept of AM and its potential role as a risk factor for stroke and dementia and in AF patients’ management strategies, highlighting the limitations of current risk stratification methods, like the CHA2DS2-VASc score. Echocardiography, particularly left atrial (LA) strain analysis, has shown to be a promising non-invasive tool for AM evaluation and recent studies suggest that LA strain analysis may be a more sensitive risk stratifier for thromboembolic events than AF itself, with some studies showing a stronger association between LA strain and thromboembolic events compared to traditional risk factors. Integrating it into routine clinical practice could improve patient management and targeted therapies for AF and potentially other thromboembolic events. Future studies are needed to explore the efficacy and safety of anticoagulation in AM patients with and without AF and to refine the diagnostic criteria for AM.

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
atrial fibrillation, atrial myopathy, left atrial strain
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-227973 (URN)10.3390/jcm13133921 (DOI)38999487 (PubMedID)2-s2.0-85198390072 (Scopus ID)
Available from: 2024-07-22 Created: 2024-07-22 Last updated: 2025-02-10Bibliographically approved
Henein, M. Y., Pilebro, B. & Lindqvist, P. (2024). Echocardiographic red flags of ATTR cardiomyopathy A single center validation. European Heart Journal - Imaging Methods and Practice
Open this publication in new window or tab >>Echocardiographic red flags of ATTR cardiomyopathy A single center validation
2024 (English)In: European Heart Journal - Imaging Methods and Practice, ISSN 2755-9637Article in journal (Refereed) Accepted
Abstract [en]

Aims: Echocardiography plays an important role in suspecting the presence of transthyretin cardiomyopathy (ATTR-CM) in patients with heart failure, based on parameters proposed as “red flags” for the diagnosis of ATTR-CM. We aimed to validate those measurements in a group of patients with ATTR-CM including ATTRv and ATTRwt.

Methods: We tested a number of echocardiographic red flags in 118 patients with confirmed diagnosis of ATTR-CM. These variables were validated against healthy controls and patients with heart failure with left ventricular hypertrophy (LVH) but not ATTR-CM. The red flag measures outside the proposed cut-off values were also revalidated.

Results: In ATTR-CM, all conventional echocardiographic parameters were significantly abnormal compared to controls. Comparing ATTR-CM and LVH, LV wall thickness, LV diameter, E velocity, and relative apical sparing (RELAPS) were all different. Eighty-three % of ATTR-CM patients had RELAPS >1.0, 73% had RWT >0.6, 72% had LVEF >50%, 24 % had GLS >-13%, 33% had LVEF/GLS >4 and 54% had increased left atrial volume index (LAVI) (>34ml/m2). Forty % of ATTR-CM patients had SVI <30 ml/m2 and 52% had CI < 2.5 L/min/m2. RELAPS, LVEF and RWT, in order of accuracy, were the three best measures for the presence ATTR-CM in the patient cohort, who all had thick myocardium. The concomitant presence of the three disturbances was found in only 50% but the combination of RELAPS >1.0 and RWT >0.6 was found in 72% of the patient cohort.

Conclusion: Increased relative apical sparing proved the most accurate independent marker of the presence of ATTR-CM followed by normal LV ejection fraction and then increased relative wall thickness. The other proposed red flags for diagnosing ATTR-CM did not feature as reliable disease predictors.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
Heart failure, transthyretin cardiomyopathy, left ventricular ejection fraction
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-230792 (URN)10.1093/ehjimp/qyae105 (DOI)
Available from: 2024-10-11 Created: 2024-10-11 Last updated: 2025-02-10
Henein, M. Y., Pilebro, B. & Lindqvist, P. (2024). Echocardiographic red flags of ATTR cardiomyopathy a single centre validation. European Heart Journal. Imaging Methods and Practice, 2(3), Article ID qyae105.
Open this publication in new window or tab >>Echocardiographic red flags of ATTR cardiomyopathy a single centre validation
2024 (English)In: European Heart Journal. Imaging Methods and Practice, E-ISSN 2755-9637, Vol. 2, no 3, article id qyae105Article in journal (Refereed) Published
Abstract [en]

Aims: Echocardiography plays an important role in suspecting the presence of transthyretin cardiomyopathy (ATTR-CM) in patients with heart failure, based on parameters proposed as ‘red flags’ for the diagnosis of ATTR-CM. We aimed to validate those measurements in a group of patients with ATTR-CM including ATTRv and ATTRwt.

Methods and results: We tested a number of echocardiographic red flags in 118 patients with confirmed diagnosis of ATTR-CM. These variables were validated against healthy controls and patients with heart failure with left ventricular hypertrophy (LVH) but not ATTR-CM. The red flag measures outside the proposed cut-off values were also revalidated. In ATTR-CM, all conventional echocardiographic parameters were significantly abnormal compared with controls. Comparing ATTR-CM and LVH, LV wall thickness, LV diameter, E velocity, and relative apical sparing (RELAPS) were all different. Eighty-three per cent of ATTR-CM patients had RELAPS > 1.0, 73% had relative wall thickness (RWT) > 0.6, 72% had LVEF > 50%, 24% had global longitudinal strain (GLS) > −13%, 33% had LVEF/GLS > 4, and 54% had increased left atrial volume index (>34 mL/m2). Forty per cent of ATTR-CM patients had stroke volume index < 30 mL/m2 and 52% had cardiac index < 2.5 L/min/m2. RELAPS, LVEF, and RWT, in order of accuracy, were the three best measures for the presence ATTR-CM in the patient cohort, who all had thick myocardium. The concomitant presence of the three disturbances was found in only 50% but the combination of RELAPS > 1.0 and RWT > 0.6 was found in 72% of the patient cohort.

Conclusion: Increased relative apical sparing proved the most accurate independent marker of the presence of ATTR-CM followed by normal LV ejection fraction and then increased relative wall thickness. The other proposed red flags for diagnosing ATTR-CM did not feature as reliable disease predictors.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
heart failure, transthyretin cardiomyopathy, left ventricular ejection fraction
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-232978 (URN)10.1093/ehjimp/qyae105 (DOI)
Funder
Swedish Heart Lung Foundation, 20160787Swedish Heart Lung Foundation, 20200160Swedish Heart Lung Foundation, 20230174Swedish Research Council, 2019-01338Swedish Research Council, 2022-01254
Available from: 2024-12-16 Created: 2024-12-16 Last updated: 2025-02-10Bibliographically approved
Dini, F. L., Cameli, M., Stefanini, A., Aboumarie, H. S., Lisi, M., Lindqvist, P. & Henein, M. Y. (2024). Echocardiography in the assessment of heart failure patients. Diagnostics, 14(23), Article ID 2730.
Open this publication in new window or tab >>Echocardiography in the assessment of heart failure patients
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2024 (English)In: Diagnostics, ISSN 2075-4418, Vol. 14, no 23, article id 2730Article in journal (Refereed) Published
Abstract [en]

Doppler echocardiography is the corner-stone of non-invasive investigation of patients with a clinical diagnosis of heart failure. It provides an accurate and quantitative assessment of cardiac structure and function. Furthermore, spectral Doppler measurement is an invaluable technique for estimating intracardiac pressures with their crucial value in the optimum management of heart failure patients, irrespective of ejection fraction. Speckle tracking echocardiography stretches the unique application of echocardiography to analyze the myocardial deformation function which has proved very accurate in detecting ischemia, dyssynchrony, subclinical dysfunction and also in estimating pulmonary capillary wedge pressures. The role of longitudinal myocardial left atrial deformation dynamics has recently emerged as a valuable tool for assessing left ventricular diastolic dysfunction in patients with cardiac diseases regardless of their ejection fraction. Finally, the extent of myocardial deformation has been shown to correlate with the severity of myocardial fibrosis, a common finding in patients with heart failure.

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
heart failure, left atrial function, cardiac output, left ventricular filling pressure, speckle tracking echocardiograph
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-232979 (URN)10.3390/diagnostics14232730 (DOI)001376961100001 ()39682638 (PubMedID)2-s2.0-85211776957 (Scopus ID)
Available from: 2024-12-16 Created: 2024-12-16 Last updated: 2025-02-10Bibliographically approved
Martini, L., Mandoli, G., Pastore, M., Pagliaro, A., Bernazzali, S., Maccherini, M., . . . Cameli, M. (2024). Heart transplantation and biomarkers: a review about their usefulness in clinical practice. Frontiers in Cardiovascular Medicine, 11, Article ID 1336011.
Open this publication in new window or tab >>Heart transplantation and biomarkers: a review about their usefulness in clinical practice
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2024 (English)In: Frontiers in Cardiovascular Medicine, E-ISSN 2297-055X, Vol. 11, article id 1336011Article, review/survey (Refereed) Published
Abstract [en]

Advanced heart failure (AdvHF) can only be treated definitively by heart transplantation (HTx), yet problems such right ventricle dysfunction (RVD), rejection, cardiac allograft vasculopathy (CAV), and primary graft dysfunction (PGD) are linked to a poor prognosis. As a result, numerous biomarkers have been investigated in an effort to identify and prevent certain diseases sooner. We looked at both established biomarkers, such as NT-proBNP, hs-troponins, and pro-inflammatory cytokines, and newer ones, such as extracellular vesicles (EVs), donor specific antibodies (DSA), gene expression profile (GEP), donor-derived cell free DNA (dd-cfDNA), microRNA (miRNA), and soluble suppression of tumorigenicity 2 (sST2). These biomarkers are typically linked to complications from HTX. We also highlight the relationships between each biomarker and one or more problems, as well as their applicability in routine clinical practice.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
biomarker, CAV, heart transplantation, PGD, rejection, RVD
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-221053 (URN)10.3389/fcvm.2024.1336011 (DOI)001156589900001 ()2-s2.0-85184163796 (Scopus ID)
Available from: 2024-02-21 Created: 2024-02-21 Last updated: 2025-02-10Bibliographically approved
Vancheri, F., Longo, G. & Henein, M. Y. (2024). Left ventricular ejection fraction: clinical, pathophysiological, and technical limitations. Frontiers in Cardiovascular Medicine, 11, Article ID 1340708.
Open this publication in new window or tab >>Left ventricular ejection fraction: clinical, pathophysiological, and technical limitations
2024 (English)In: Frontiers in Cardiovascular Medicine, E-ISSN 2297-055X, Vol. 11, article id 1340708Article, review/survey (Refereed) Published
Abstract [en]

Risk stratification of cardiovascular death and treatment strategies in patients with heart failure (HF), the optimal timing for valve replacement, and the selection of patients for implantable cardioverter defibrillators are based on an echocardiographic calculation of left ventricular ejection fraction (LVEF) in most guidelines. As a marker of systolic function, LVEF has important limitations being affected by loading conditions and cavity geometry, as well as image quality, thus impacting inter- and intra-observer measurement variability. LVEF is a product of shortening of the three components of myocardial fibres: longitudinal, circumferential, and oblique. It is therefore a marker of global ejection performance based on cavity volume changes, rather than directly reflecting myocardial contractile function, hence may be normal even when myofibril's systolic function is impaired. Sub-endocardial longitudinal fibers are the most sensitive layers to ischemia, so when dysfunctional, the circumferential fibers may compensate for it and maintain the overall LVEF. Likewise, in patients with HF, LVEF is used to stratify subgroups, an approach that has prognostic implications but without a direct relationship. HF is a dynamic disease that may worsen or improve over time according to the underlying pathology. Such dynamicity impacts LVEF and its use to guide treatment. The same applies to changes in LVEF following interventional procedures. In this review, we analyze the clinical, pathophysiological, and technical limitations of LVEF across a wide range of cardiovascular pathologies.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
aortic regurgitation, aortic stenosis, echocardiography, implantable cardioverter defibrillator, left ventricular ejection fraction, mitral regurgitation
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-221673 (URN)10.3389/fcvm.2024.1340708 (DOI)38385136 (PubMedID)2-s2.0-85185511174 (Scopus ID)
Available from: 2024-02-29 Created: 2024-02-29 Last updated: 2025-02-10Bibliographically approved
Mandoli, G. E., Cameli, M., Pastore, M. C., Loiacono, F., Righini, F. M., D’Ascenzi, F., . . . Henein, M. Y. (2024). Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure. European Heart Journal Cardiovascular Imaging, 25(4), 446-453
Open this publication in new window or tab >>Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure
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2024 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 25, no 4, p. 446-453Article in journal (Refereed) Published
Abstract [en]

Aims: Advanced heart failure (AdHF) is characterized by variable degrees of left ventricular (LV) dysfunction, myocardial fibrosis, and raised filling pressures which lead to left atrial (LA) dilatation and cavity dysfunction. This study investigated the relationship between LA peak atrial longitudinal strain (PALS), assessed by speckle-tracking echocardiography (STE), and invasive measures of LV filling pressures and fibrosis in a group of AdHF patients undergoing heart transplantation (HTX).

Methods and results: We consecutively enrolled patients with AdHF who underwent HTX at our Department. Demographic and basic echocardiographic data were registered, then invasive intracardiac pressures were obtained from right heart catheterization, and STE was also performed. After HTX, biopsy specimens from explanted hearts were collected to quantify the degree of LV myocardial fibrosis. Sixty-four patients were included in the study (mean age 62.5 ± 11 years, 42% female). The mean LV ejection fraction (LVEF) was 26.7 ± 6.1%, global PALS was 9.65 ± 4.5%, and mean pulmonary capillary wedge pressure (PCWP) was 18.8 ± 4.8 mmHg. Seventy-three % of patients proved to have severe LV fibrosis. Global PALS was inversely correlated with PCWP (R = −0.83; P < 0.0001) and with LV fibrosis severity (R = −0.78; P < 0.0001) but did not correlate with LVEF (R = 0.15; P = 0.2). Among echocardiographic indices of LV filling pressures, global PALS proved the strongest [area under the curve 0.955 (95% confidence interval 0.87–0.99)] predictor of raised (>18 mmHg) PCWP.

Conclusion: In patients with AdHF, reduced global PALS strongly correlated with the invasively assessed LV filling pressure and degree of LV fibrosis. Such relationship could be used as non-invasive indicator for optimum patient stratification for therapeutic strategies.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
biopsy, fibrosis, heart failure, left atrial strain, pulmonary capillary wedge pressure, transplantation
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-223228 (URN)10.1093/ehjci/jead340 (DOI)001134743800001 ()38109280 (PubMedID)2-s2.0-85188188770 (Scopus ID)
Available from: 2024-04-19 Created: 2024-04-19 Last updated: 2025-02-10Bibliographically approved
Batalli, A., Henein, M. Y., Poniku, A., Ibrahimi, P., Pllana-Pruthi, E., Elezi, S., . . . Bajraktari, G. (2024). Management and clinical outcome of myocardial infarction in Kosovo: a cross-sectional study. Health Science Reports, 7(10), Article ID e70122.
Open this publication in new window or tab >>Management and clinical outcome of myocardial infarction in Kosovo: a cross-sectional study
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2024 (English)In: Health Science Reports, E-ISSN 2398-8835, Vol. 7, no 10, article id e70122Article in journal (Refereed) Published
Abstract [en]

Background and Aims: Myocardial infarction (MI) is a major cause of mortality worldwide, irrespective of its presentation as non-ST-segment elevation MI (NSTEMI) or ST-segment elevation MI (STEMI). The objective of this study was to assess national results of management and clinical outcome of acute MI patients in Kosovo.

Methods: This cross-sectional descriptive study, conducted at the Clinic of Cardiology of the University Clinical Center of Kosovo, in Prishtina, included all patients hospitalized with acute MI over a period of 7 years (2014-2020). The primary outcome of the study was in-hospital mortality.

Results: Among 7353 admitted patients with acute MI (mean age 63 ± 12 years, 29% female) and according to the final diagnosis, 4436 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. More patients with STEMI received primary percutaneous intervention (PPCI) than those with NSTEMI (50% vs. 41%, p < 0.001). In-hospital mortality was higher in no PPCI patients compared to PPCI both in NSTEMI (10.7% vs. 2.6%, p < 0.001) and STEMI (20.9% vs. 6.8%, p < 0.001). Age ≥65 years [0.399 (0.267–0.597), p ˂ 0.001], hemoglobin level [0.889 (0.815–0.970), p = 0.008], STEMI [0.491 (0.343–0.704), p ˂ 0.001], lack of PPCI [2.636 (1.798–3.866), p ˂ 0.001], cardiogenic shock [0.002 (0.001–0.006), p < 0.001], reduced left ventricular ejection fraction (LV EF) [0.966 (0.951–0.980), p < 0.001], and heart rate at admission [1.009 (1.000–1.017), p = 0.047], independently predicted mortality. In STEMI, cardiogenic shock (p ˂ 0.001), lack of PPCI (p = 0.006), female gender (p = 0.01), and low LV EF (p = 0.04) predicted mortality but age ≥65 years (p = 0.02), female gender (p = 0.02), low LV EF (p = 0.007), and low hemoglobin (p = 0.04) predicted mortality in NSTEMI.

Conclusion: Between 2014 and 2020, half of patients with acute MI were not treated with PPCI, who had high mortality, particularly when presenting with STEMI. Age, cardiogenic shock, anemia, low LV EF, STEMI and no PPCI independently predicted mortality. Cardiogenic shock and lack of PPCI independently predicted mortality, only in STEMI.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
acute myocardial infarction, Kosovo, mortality, primary PCI
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-231302 (URN)10.1002/hsr2.70122 (DOI)001334255500001 ()39421209 (PubMedID)2-s2.0-85206814463 (Scopus ID)
Available from: 2024-11-06 Created: 2024-11-06 Last updated: 2025-02-10Bibliographically approved
Mandoli, G. E., Landra, F., Chiantini, B., Bonadiman, L., Pastore, M. C., Focardi, M., . . . Henein, M. Y. (2024). Myocardial work indices predict hospitalization in patients with advanced heart failure. Diagnostics, 14(11), Article ID 1196.
Open this publication in new window or tab >>Myocardial work indices predict hospitalization in patients with advanced heart failure
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2024 (English)In: Diagnostics, ISSN 2075-4418, Vol. 14, no 11, article id 1196Article in journal (Refereed) Published
Abstract [en]

Background: An increasing proportion of heart failure (HF) patients progress to the advanced stage (AdHF) with high event rates and limited treatment options. Echocardiography, particularly Speckle Tracking-derived myocardial work (MW), is useful for HF diagnosis and prognosis. We aimed to assess MW’s feasibility in the prognostic stratification of AdHF.

Methods: We retrospectively screened patients with AdHF who accessed our hospital in 2018–2022. We excluded subjects with inadequate acoustic windows; unavailable brachial artery cuff pressure at the time of the echocardiography; atrial fibrillation; and mitral or aortic regurgitation. We measured standard parameters and left ventricular (LV) strain (LS) and MW. The population was followed up to determine the composite outcomes of all-cause mortality, left ventricular assist device implantation and heart transplantation (primary endpoint), as well as unplanned HF hospitalization (secondary endpoint).

Results: We enrolled 138 patients, prevalently males (79.7%), with a median age of 58 years (IQR 50–62). AdHF etiology was predominantly non-ischemic (65.9%). Thirty-five patients developed a composite event during a median follow-up of 636 days (IQR 323–868). Diastolic function, pulmonary pressures, and LV GLS and LV MW indices were not associated with major events. Contrarily, for the secondary endpoint, the hazard ratio for each increase in global work index (GWI) by 50 mmHg% was 0.90 (p = 0.025) and for each increase in global constructive work (GCW) by 50 mmHg% was 0.90 (p = 0.022). Kaplan–Meier demonstrated better endpoint-free survival, with an LV GWI ≥ 369 mmHg%.

Conclusions: GWI and GCW, with good feasibility, can help in the better characterization of patients with AdHF at higher risk of HF hospitalization and adverse events, identifying the need for closer follow-up or additional HF therapy.

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
end-stage heart failure, myocardial work, prognosis, speckle tracking
National Category
Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-226959 (URN)10.3390/diagnostics14111196 (DOI)001245560800001 ()38893722 (PubMedID)2-s2.0-85195949733 (Scopus ID)
Available from: 2024-06-24 Created: 2024-06-24 Last updated: 2025-02-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6089-5614

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