Cargando…
Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification
AIMS: Left ventricular systolic dysfunction (LSVD) is a heterogeneous condition with several factors influencing prognosis. Better phenotyping of asymptomatic individuals can inform preventative strategies. This study aims to explore the clinical phenotypes of LVSD in initially asymptomatic subjects...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531121/ https://www.ncbi.nlm.nih.gov/pubmed/37699069 http://dx.doi.org/10.1093/ehjci/jead218 |
_version_ | 1785111644070739968 |
---|---|
author | Rauseo, Elisa Abdulkareem, Musa Khan, Abbas Cooper, Jackie Lee, Aaron M Aung, Nay Slabaugh, Gregory G Petersen, Steffen E |
author_facet | Rauseo, Elisa Abdulkareem, Musa Khan, Abbas Cooper, Jackie Lee, Aaron M Aung, Nay Slabaugh, Gregory G Petersen, Steffen E |
author_sort | Rauseo, Elisa |
collection | PubMed |
description | AIMS: Left ventricular systolic dysfunction (LSVD) is a heterogeneous condition with several factors influencing prognosis. Better phenotyping of asymptomatic individuals can inform preventative strategies. This study aims to explore the clinical phenotypes of LVSD in initially asymptomatic subjects and their association with clinical outcomes and cardiovascular abnormalities through multi-dimensional data clustering. METHODS AND RESULTS: Clustering analysis was performed on 60 clinically available variables from 1563 UK Biobank participants without pre-existing heart failure (HF) and with left ventricular ejection fraction (LVEF) < 50% on cardiovascular magnetic resonance (CMR) assessment. Risks of developing HF, other cardiovascular events, death, and a composite of major adverse cardiovascular events (MACE) associated with clusters were investigated. Cardiovascular imaging characteristics, not included in the clustering analysis, were also evaluated. Three distinct clusters were identified, differing considerably in lifestyle habits, cardiovascular risk factors, electrocardiographic parameters, and cardiometabolic profiles. A stepwise increase in risk profile was observed from Cluster 1 to Cluster 3, independent of traditional risk factors and LVEF. Compared with Cluster 1, the lowest risk subset, the risk of MACE ranged from 1.42 [95% confidence interval (CI): 1.03–1.96; P < 0.05] for Cluster 2 to 1.72 (95% CI: 1.36–2.35; P < 0.001) for Cluster 3. Cluster 3, the highest risk profile, had features of adverse cardiovascular imaging with the greatest LV re-modelling, myocardial dysfunction, and decrease in arterial compliance. CONCLUSIONS: Clustering of clinical variables identified three distinct risk profiles and clinical trajectories of LVSD amongst initially asymptomatic subjects. Improved characterization may facilitate tailored interventions based on the LVSD sub-type and improve clinical outcomes. |
format | Online Article Text |
id | pubmed-10531121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105311212023-09-28 Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification Rauseo, Elisa Abdulkareem, Musa Khan, Abbas Cooper, Jackie Lee, Aaron M Aung, Nay Slabaugh, Gregory G Petersen, Steffen E Eur Heart J Cardiovasc Imaging Original Paper AIMS: Left ventricular systolic dysfunction (LSVD) is a heterogeneous condition with several factors influencing prognosis. Better phenotyping of asymptomatic individuals can inform preventative strategies. This study aims to explore the clinical phenotypes of LVSD in initially asymptomatic subjects and their association with clinical outcomes and cardiovascular abnormalities through multi-dimensional data clustering. METHODS AND RESULTS: Clustering analysis was performed on 60 clinically available variables from 1563 UK Biobank participants without pre-existing heart failure (HF) and with left ventricular ejection fraction (LVEF) < 50% on cardiovascular magnetic resonance (CMR) assessment. Risks of developing HF, other cardiovascular events, death, and a composite of major adverse cardiovascular events (MACE) associated with clusters were investigated. Cardiovascular imaging characteristics, not included in the clustering analysis, were also evaluated. Three distinct clusters were identified, differing considerably in lifestyle habits, cardiovascular risk factors, electrocardiographic parameters, and cardiometabolic profiles. A stepwise increase in risk profile was observed from Cluster 1 to Cluster 3, independent of traditional risk factors and LVEF. Compared with Cluster 1, the lowest risk subset, the risk of MACE ranged from 1.42 [95% confidence interval (CI): 1.03–1.96; P < 0.05] for Cluster 2 to 1.72 (95% CI: 1.36–2.35; P < 0.001) for Cluster 3. Cluster 3, the highest risk profile, had features of adverse cardiovascular imaging with the greatest LV re-modelling, myocardial dysfunction, and decrease in arterial compliance. CONCLUSIONS: Clustering of clinical variables identified three distinct risk profiles and clinical trajectories of LVSD amongst initially asymptomatic subjects. Improved characterization may facilitate tailored interventions based on the LVSD sub-type and improve clinical outcomes. Oxford University Press 2023-09-12 /pmc/articles/PMC10531121/ /pubmed/37699069 http://dx.doi.org/10.1093/ehjci/jead218 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Paper Rauseo, Elisa Abdulkareem, Musa Khan, Abbas Cooper, Jackie Lee, Aaron M Aung, Nay Slabaugh, Gregory G Petersen, Steffen E Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title | Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title_full | Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title_fullStr | Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title_full_unstemmed | Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title_short | Phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
title_sort | phenotyping left ventricular systolic dysfunction in asymptomatic individuals for improved risk stratification |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531121/ https://www.ncbi.nlm.nih.gov/pubmed/37699069 http://dx.doi.org/10.1093/ehjci/jead218 |
work_keys_str_mv | AT rauseoelisa phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT abdulkareemmusa phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT khanabbas phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT cooperjackie phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT leeaaronm phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT aungnay phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT slabaughgregoryg phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification AT petersensteffene phenotypingleftventricularsystolicdysfunctioninasymptomaticindividualsforimprovedriskstratification |