Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study
Background Left ventricular diastolic function as assessed by tissue Doppler echocardiography predicts cardiovascular event rates at 4 years of follow-up in patients with hypertension. Our aim was to evaluate whether this extends to predicting cardiovascular mortality after 20 years of follow-up.Met...
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BMJ Publishing Group
2025-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e002795.full |
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| author | Simon Thom Alice Stanton Jamil Mayet Amit Kaura Darrel Francis Anoop SV Shah Andrew Sharp Alun D Hughes Neil R Poulter Anenta Ratneswaren Tong Wu Somayeh Rostamian Devan Wasan PS Sever |
| author_facet | Simon Thom Alice Stanton Jamil Mayet Amit Kaura Darrel Francis Anoop SV Shah Andrew Sharp Alun D Hughes Neil R Poulter Anenta Ratneswaren Tong Wu Somayeh Rostamian Devan Wasan PS Sever |
| author_sort | Simon Thom |
| collection | DOAJ |
| description | Background Left ventricular diastolic function as assessed by tissue Doppler echocardiography predicts cardiovascular event rates at 4 years of follow-up in patients with hypertension. Our aim was to evaluate whether this extends to predicting cardiovascular mortality after 20 years of follow-up.Methods Conventional (E) and tissue Doppler (e′) echocardiography was performed on hypertensive participants in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) with long-term follow-up ascertained via linkage to the Office of National Statistics. Cardiovascular mortality was defined as death from coronary heart disease, stroke and other cardiovascular aetiology such as heart failure or peripheral vascular disease. Unadjusted and adjusted Cox regression survival models were constructed to investigate the association between tissue Doppler echocardiography measurements and long-term cardiovascular mortality.Results Among 506 hypertensive patients (median age 64, interquartile range (58, 69), 87% male), there were 200 (40%) deaths over a 20-year follow-up period. 60 deaths (12%) were cardiovascular-related.A reduction in e′ was independently associated with increased cardiovascular mortality, after adjusting for the ACC/AHA Atherosclerotic Cardiovascular Disease (ASCVD) risk score, with an inverse HR of 1.22 per 1 cm/s decrease (95% CI 1.04–1.43). A higher E/e′ ratio was independently associated with increased cardiovascular mortality, after adjusting for the ASCVD risk score, with an HR of 1.12 per 1-unit increase (95% CI, 1.02 to 1.23).Conclusions Impaired left ventricular diastolic function, measured using tissue Doppler echocardiography through e′ and E/e′, independently predicts increased cardiovascular mortality over 20 years in hypertensive patients, highlighting its long-term prognostic significance. |
| format | Article |
| id | doaj-art-3e23d282608646fcb40c73042fbf5c4c |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-3e23d282608646fcb40c73042fbf5c4c2025-02-05T04:00:13ZengBMJ Publishing GroupOpen Heart2053-36242025-02-0112110.1136/openhrt-2024-002795Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up studySimon Thom0Alice Stanton1Jamil Mayet2Amit Kaura3Darrel Francis4Anoop SV Shah5Andrew Sharp6Alun D Hughes7Neil R Poulter8Anenta Ratneswaren9Tong Wu10Somayeh Rostamian11Devan Wasan12PS Sever131 National Heart and Lung Institute, Imperial College London, London, UK4 Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK3 Imperial College Healthcare NHS Trust, London, UK2 University Hospital of Wales, Cardiff, UK, Cardiff, UK5 University College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UK1 National Heart and Lung Institute, Imperial College London, London, UKBackground Left ventricular diastolic function as assessed by tissue Doppler echocardiography predicts cardiovascular event rates at 4 years of follow-up in patients with hypertension. Our aim was to evaluate whether this extends to predicting cardiovascular mortality after 20 years of follow-up.Methods Conventional (E) and tissue Doppler (e′) echocardiography was performed on hypertensive participants in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) with long-term follow-up ascertained via linkage to the Office of National Statistics. Cardiovascular mortality was defined as death from coronary heart disease, stroke and other cardiovascular aetiology such as heart failure or peripheral vascular disease. Unadjusted and adjusted Cox regression survival models were constructed to investigate the association between tissue Doppler echocardiography measurements and long-term cardiovascular mortality.Results Among 506 hypertensive patients (median age 64, interquartile range (58, 69), 87% male), there were 200 (40%) deaths over a 20-year follow-up period. 60 deaths (12%) were cardiovascular-related.A reduction in e′ was independently associated with increased cardiovascular mortality, after adjusting for the ACC/AHA Atherosclerotic Cardiovascular Disease (ASCVD) risk score, with an inverse HR of 1.22 per 1 cm/s decrease (95% CI 1.04–1.43). A higher E/e′ ratio was independently associated with increased cardiovascular mortality, after adjusting for the ASCVD risk score, with an HR of 1.12 per 1-unit increase (95% CI, 1.02 to 1.23).Conclusions Impaired left ventricular diastolic function, measured using tissue Doppler echocardiography through e′ and E/e′, independently predicts increased cardiovascular mortality over 20 years in hypertensive patients, highlighting its long-term prognostic significance.https://openheart.bmj.com/content/12/1/e002795.full |
| spellingShingle | Simon Thom Alice Stanton Jamil Mayet Amit Kaura Darrel Francis Anoop SV Shah Andrew Sharp Alun D Hughes Neil R Poulter Anenta Ratneswaren Tong Wu Somayeh Rostamian Devan Wasan PS Sever Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study Open Heart |
| title | Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study |
| title_full | Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study |
| title_fullStr | Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study |
| title_full_unstemmed | Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study |
| title_short | Tissue Doppler echocardiography predicts long-term cardiovascular mortality: the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) legacy 20-year follow-up study |
| title_sort | tissue doppler echocardiography predicts long term cardiovascular mortality the anglo scandinavian cardiac outcomes trial ascot legacy 20 year follow up study |
| url | https://openheart.bmj.com/content/12/1/e002795.full |
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