25 research outputs found
PROGNOSTIC VALUE OF LEFT VENTRICLE FUNCTION BY TISSUE DOPPLER STRAIN IMAGING IN PATIENTS WITH SEVERE SEPSIS OR SEPTIC SHOCK
PROGNOSTIC VALUE OF LEFT VENTRICLE FUNCTION BY TISSUE DOPPLER STRAIN IMAGING IN PATIENTS WITH SEVERE SEPSIS OR SEPTIC SHOCK
2-D ULTRASOUND SPECKLE TRACKING STRAIN IMAGING OF THE LEFT ATRIUM IN THE ESTIMATION OF LEFT VENTRICULAR FILLING PRESSURES.
Papillary muscle dysfunction attenuates ischemic mitral regurgitation in patients with localized basal inferior left ventricular remodeling
Papillary muscle dysfunction attenuates ischemic mitral regurgitation in patients with localized basal inferior left ventricular remodeling
868-3 Comparison of left ventricular sphericity and papillary muscle tethering in the mechanism of ischemic mitral regurgitation in patients with inferior myocardial infarction
Dynamic diastologic stress echocardiography with minimal exercise enables prediction of exercise tolerance in patients with congestive heart failure
Network Analysis of Cardiac Remodeling by Primary Mitral Regurgitation Emphasizes the Role of Diastolic Function
© 2022 American College of Cardiology FoundationBackground: Topological data analysis (TDA) can generate patient-patient similarity networks by analyzing large, complex data and derive new insights that may not be possible with standard statistics. Objectives: The purpose of this paper was to discover novel phenotypes of chronic primary mitral regurgitation (MR) patients and to analyze their clinical implications using network analysis of echocardiographic data. Methods: Patients with chronic moderate to severe primary MR were prospectively enrolled from 11 Asian tertiary hospitals (n = 850; mean age 56.9 ± 14.2 years, 57.9% men). We performed TDA to generate network models using 14 demographic and echocardiographic variables. The patients were grouped by phenotypes in the network, and the prognosis was compared by groups. Results: The network model by TDA revealed 3 distinct phenogroups. Group A was the youngest with fewer comorbidities but increased left ventricular (LV) end-systolic volume, representing compensatory LV dilation commonly seen in chronic primary MR. Group B was the oldest with high blood pressure and a predominant diastolic dysfunction but relatively preserved LV size, an unnoticed phenotype in chronic primary MR. Group C showed advanced LV remodeling with impaired systolic, diastolic function, and LV dilation, indicating advanced chronic primary MR. During follow-up (median 3.5 years), 60 patients received surgery for symptomatic MR or died of cardiovascular causes. Kaplan-Meier curves demonstrated that although group C had the worst clinical outcome (P < 0.001), group B, characterized by diastolic dysfunction, had an event-free survival comparable to group A despite preserved LV chamber size. The grouping information by the network model was an independent predictor for the composite of MR surgery or cardiovascular death (adjusted HR: 1.918; 95% CI: 1.257-2.927; P = 0.003). Conclusions: The patient-patient similarity network by TDA visualized diverse remodeling patterns in chronic primary MR and revealed distinct phenotypes not emphasized currently. Importantly, diastolic dysfunction deserves equal attention when understanding the clinical presentation of chronic primary MR.N