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Echocardiographic Predictors of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study.
Wednesday,2016-08-17 16:31 America/Los_Angeles — zdrager
| Title | Echocardiographic Predictors of Sudden Cardiac Death: The Atherosclerosis Risk in Communities Study and Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Konety, SH, Koene, RJ, Norby, FL, Wilsdon, T, Alonso, A, Siscovick, D, Sotoodehnia, N, Gottdiener, J, Fox, ER, Chen, LY, Adabag, S, Folsom, AR |
| Journal | Circ Cardiovasc Imaging |
| Volume | 9 |
| Issue | 8 |
| Date Published | 2016 Aug |
| ISSN | 1942-0080 |
| Abstract | <p><b>BACKGROUND: </b>This study assessed the echocardiographic predictors of sudden cardiac death (SCD) within 2 population-based cohorts.</p><p><b>METHODS AND RESULTS: </b>Echocardiograms were obtained on 2383 participants (1993-1995) from the ARIC study (Atherosclerosis Risk in Communities; 100% black) and 5366 participants (1987-1989 and 1994-1995) from the CHS (Cardiovascular Health Study). The main outcome was physician-adjudicated SCD. We used Cox proportional-hazards models with incident coronary heart disease and heart failure as time-dependent covariates to assess the association between echocardiographic variables and SCD, adjusting for Framingham risk score variables, coronary heart disease, and renal function. Cohort-specific results were meta-analyzed. During a median follow-up of 7.3 and 13.1 years, 44 ARIC study participants and 275 CHS participants had SCD, respectively. In the meta-analyzed results, the adjusted hazard ratios (95% confidence intervals) for predictors of SCD were 3.07 (2.29-4.11) for reduced left ventricular ejection fraction; 1.85 (1.36-2.52) for mitral annular calcification; 1.64 (1.07-2.51) for mitral E/A >1.5, and 1.52 (1.14-2.02) for mitral E/A <0.7 (versus mitral E/A 0.7-1.5); 1.30 (1.15-1.48) per 1 SD increase in left ventricular mass; and 1.15 (1.02-1.30) per 1 SD increase in left atrial diameter. A receiver-operating characteristic model for prediction of SCD using Framingham risk score variables had a C statistic of 0.61 for ARIC study and 0.67 for CHS; the full multivariable model including all echocardiographic variables had a C statistic of 0.76 for ARIC study and 0.74 for CHS.</p><p><b>CONCLUSIONS: </b>In addition to reduced left ventricular ejection fraction, we identified other echocardiographic-derived variables predictive for SCD that provided incremental value compared with clinical risk factors.</p> |
| DOI | 10.1161/CIRCIMAGING.115.004431 |
| Alternate Journal | Circ Cardiovasc Imaging |
| PubMed ID | 27496550 |
| PubMed Central ID | PMC5010094 |
| Grant List | N01 HC055019 / HC / NHLBI NIH HHS / United States |