Page 100 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

Chapter five. Layer-specific LV GLS and remodeling
Independent correlates of adverse LV remodeling
Uni- and multivariable analyses were performed to evaluate the correlates of adverse LV remodeling from baseline to 6 months follow-up. On univariable analysis body surface area (BSA), discharge heart rate, diabetes mellitus, peak troponin levels, baseline LVEF, baseline WMSI, significant MR, left anterior descending coronary artery (LAD) as culprit vessel and Killip class ≥2 were significantly correlated with adverse LV remodeling (p<0.2 for all; Table 4). On multivariable regression analysis only BSA (odds ratio [OR] 0.372; p =0.049), heart rate at discharge (OR 1.019; p =0.014) and peak troponin level (OR 1.048; p =0.009) were independently associated with adverse LV remodeling (Table 4).
Table 4. Uni- and multivariable logistic regression analysis to investigate independent correlates of adverse left ventricular remodeling
Variable
Univariable analysis
Model 1 (baseline model)
β
95% confidence interval
p-value
β
95% confidence interval
p-value
Age, years
Gender (male)
BSA (m2)
Heart rate, at discharge
Diabetes mellitus
Hypertension 1.051
0.992-1.024 0.781-1.818 0.159-1.048 1.012-1.041 0.952-3.343 0.701-1574 0.387-4.205 0.441-2.551 0.136-3.677
1.025-1.093 0.949-9.92
0.819-3.246
0.219-1.240
0.995-1.007
0.545-1.130 0.804-4.159 0.738-1.534
0.338 0.416 0.063 <0.001 0.071 0.810 0.688 0.896 0.679
0.001 0.007
0.164
0.141
0.704
0.193 0.150 0.738
----
---- 0.372 1.019 1.771 ---- ---- ---- ----
1.048 0.982
0.770
0.424
----
0.937 1.712 ----
----------
---------- 0.139-0.997 1.004-1.035 0.914-3.429 ---------- ---------- ---------- ----------
1.012-1.085 0.959-1.005
0.344-1.723 0.170-1.061 ----------
0.627-1.401 0.709-4.133 ----------
-----
-----
0.049 0.014 0.090 ----- ----- ----- -----
0.009
0.127
0.524
0.067
-----
0.752 0.232 -----
ACEi/ARBs, at discharge β-blockers, at discharge
Aldosterone antagonists, at discharge
Peak cTnT (μg/L)
LV ejection fraction (%), at baseline
Wall motion score index, at baseline
Mitral regurgitation ≥2, at baseline
LV mass (indexed), at baseline
LAD as culprit vessel Killip class ≥2, at baseline
Multi-vessel disease, at baseline
1.276 1.060 0.706
1.058 0.970
1.630
0.521
1.001
0.785 1.828 1.064
1.008 1.192 0.408 1.027 1.784
ACE = angiotensin converting enzyme; ARB = angiotensin receptor blocker; BSA = body surface area; cTnT = cardiac troponin T; LAD = left anterior descending coronary artery; LV= left ventricular
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