Page 120 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou
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Chapter six. Layer-specific LV GLS and prognosis
Table 3. Univariable and multivariable Cox proportional hazard models for all-cause mortality
 Variable
  Univariable analysis
  Model 1 (baseline model)
 HR
  95% CI
  p value
   HR
  95% CI
  p value
  Age (years)
Gender (male)
Body mass, indexed (kg/m2)
Heart rate, at discharge
Diabetes mellitus
ACEi/ARBs, at discharge
β-blockers, at discharge
Peak cTnT (μg/L) , at baseline
eGFR (ml/min/1.73m2) , at baseline
LAD as culprit vessel Killip class ≥2, at baseline
Multi-vessel disease, at baseline
LV ejection fraction (%), at baseline
LV end-diastolic diameter (mm) , at baseline
LV end-systolic diameter (mm) , at baseline
Wall motion score index, at baseline
Mitral regurgitation ≥2, at baseline
LV mass (indexed), at baseline
1.106 1.550 0.933 1.019 1.548 0.659 0.775 1.006
0.981
1.137 3.696 1.590
0.992 0.989 0.985 1.041 1.154 1.003
1.083-1.129 <0.001 1.098
1.071-1.125 <0.001
1.006-2.390 0.878-0.991 1.003-1.036 0.852-3.902 0.241-1.797 0.339-1.773 0.967-1.045
0.973-0.988
0.748-1.728 1.915-7.134 1.060-2.385
0.959-1.027 0.982-0.996 0.972-0.997 0.472-2.296 0.827-1.611 0.996-1.010
0.047 0.723 0.024 0.961 0.017 1.010 0.174 ---- 0.415 ---- 0.546 ----
0.778 ---- <0.001 0.994
0.548 ---- <0.001 1.569 0.025 1.017
0.666 ----
0.001 0.995
0.019 1.009
0.921 ---- ---------- ----- 0.398 ---- ---------- ----- 0.443 ---- ---------- -----
0.428-1.222 0.898-1.028 0.992-1.028 ---------- ---------- ---------- ----------
0.987-1.002
---------- 0.722-3.408 0.657-1.575
0.226 0.247 0.290 ----- ----- ----- -----
0.126
----- 0.255 0.940
---------- 0.983-1.008 0.986-1.033
----- 0.462 0.447
 ACE = angiotensin converting enzyme; ARB = angiotensin receptor blocker; CI= confidence interval; cTnT = cardiac troponin T; HR= Hazard ratio; LAD = left anterior descending coronary artery; LV= left ventricular
Subsequently, on multivariable analysis only age (HR=1.098; [95%CI; 1.071 to 1.125], p<0.001) remained independently associated with all-cause mortality (Table 3). To investigate the independent association of multi-layer global longitudinal strain, 3 different models were developed, each of them including one of the LV layers. The correlation coefficient between each LV layer-specific GLS was >0.7 (endocardial vs. mid-myocardium; r=0.991, p<0.001), (endocardial vs. epicardium; r=0.954, p<0.001) and (mid-myocardium vs. epicardium; r=0.985, p<0.001). Therefore, to avoid multicollinearity these variables were not forced into the same multivariate model and were introduced in 3 separate multivariate models with similar baseline variables.
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