Lassen MCH, et al. - The ratio of early mitral inflow velocity to global diastolic strain rate (E/e'sr) has been shown to be a significant predictor of cardiac events in specific patient populations, so researchers sought the utility of this measurement to predict cardiovascular events in a general population. E/e'sr provided independent and incremental prognostic information regarding cardiovascular morbidity and mortality in the general population. Furthermore, E/e'sr was noted to be a stronger predictor of cardiac events than E/e'.

Methods

• In a general population study, a total of 1,238 participants underwent a health examination, including echocardiography, where global longitudinal strain (GLS) and E/e'sr were established.
• A composite of incident heart failure (HF), acute myocardial infarction (AMI) or cardiovascular death (CVD) was the primary endpoint.

Results

• One hundred and forty (11.3%) participants reached the composite endpoint during follow-up (median 11 years).
• Researchers noted E/e'sr was associated with adverse outcome (HR 1.17 95% CI [1.13–1.21]; P <0.001, per 10 cm increase).
• E/e'sr remained an independent predictor of the composite endpoint (HR 1.08, 95% CI [1.02–1.13]; P=0.003) vs E/e' (HR 1.03, 95% CI [0.99–1.06]; P=0.11 per 1 unit increase) after multivariable adjustment for echocardiographic and clinical parameters.
• Global longitudinal strain influenced the relationship between E/e'sr and outcome (P for interaction=0.015).
• After multivariable adjustment, E/e'sr was a stronger predictor in participants with good systolic function as determined by GLS (GLS>18%), compared to those with reduced systolic function (GLS<18%) (HR 1.28 95% CI [1.06–1.54]; P=0.011, and HR 1.08 95% CI [1.02–1.14]; P=0.012, respectively).