Temporal Release of High-Sensitivity Cardiac Troponin T and I and Copeptin After Brief Induced Coronary Artery Balloon Occlusion in Humans.

Background: Cardiac troponins (cTns) are the cornerstone of diagnosing acute myocardial infarction. There is limited knowledge on the duration of ischemia necessary to induce a measurable release of cTns or the very-early-release kinetics of cTns after an ischemic event. Copeptin may have a supplementary role in ruling out myocardial infarction early.

Duration of early systolic lengthening: prognostic potential in the general population.

Background: When the left ventricle pressure rises during early systole, myocardial fibres with reduced contractility tend to stretch instead of shortening. This interval is known as duration of early systolic lengthening (DESL). We sought to investigate if DESL provides prognostic information on cardiovascular events.

The cardiac isovolumetric contraction time is an independent predictor of incident atrial fibrillation and adverse outcomes following first atrial fibrillation event in the general population.

Aims: Colour tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to obtain cardiac time intervals including the isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and ejection time (ET). The myocardial performance index (MPI) was defined as [(IVCT + IVRT)/ET]. Our aim was to investigate if cardiac time intervals can be used to predict atrial fibrillation (AF) in the general population.

Influenza Vaccine in Heart Failure.

Background: Influenza infection is a serious event for patients with heart failure (HF). Little knowledge exists about the association between influenza vaccination and outcome in patients with HF. This study sought to determine whether influenza vaccination is associated with improved long-term survival in patients with newly diagnosed HF.

Echocardiographic Predictors of Mortality in Women With Heart Failure With Reduced Ejection Fraction.

Background: Previous studies found that global longitudinal strain is a superior predictor of mortality in male patients with heart failure with reduced ejection fraction (EF). This does not apply to women. Our aim was to investigate sex-specific differences in cardiac function and identify echocardiographic predictors of mortality in women with heart failure with reduced EF.

Early Versus Standard Care Invasive Examination and Treatment of Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.

Background: The optimal timing of invasive coronary angiography (ICA) and revascularization in patients with non-ST-segment elevation acute coronary syndrome is not well defined. We tested the hypothesis that a strategy of very early ICA and possible revascularization within 12 hours of diagnosis is superior to an invasive strategy performed within 48 to 72 hours in terms of clinical outcomes.

Methods: Patients admitted with clinical suspicion of non-ST-segment elevation acute coronary syndrome in the Capital Region of Copenhagen, Denmark, were screened for inclusion in the VERDICT trial (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography) ( ClinicalTrials.

Prognostic value of left atrial strain in predicting cardiovascular morbidity and mortality in the general population.

Aims: Left atrial (LA) enlargement predicts cardiovascular risk. The prognostic value of left atrial peak reservoir strain (LA RS) by two-dimensional speckle tracking in the general population is currently unknown. This study sought to determine the prognostic value of LA RS in the general population.

Post-systolic shortening predicts heart failure following acute coronary syndrome.

Background: Post-systolic shortening (PSS) is a novel echocardiographic marker of myocardial dysfunction. Our objective was to assess the prognostic value of PSS in patients following acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).

Methods: A total of 428 patients hospitalized for ACS (mean age 64 ± 12 years, male 73%) underwent speckle tracking echocardiography following treatment with PCI (median 2 days).

Prognostic Value of Left Atrial Functional Measures in Heart Failure With Reduced Ejection Fraction.

Background: The prognostic value of LA functional measures in heart failure patients with reduced ejection fraction (HFrEF) is unclear. Therefore, this study investigated the prognostic value of left atrial (LA) functional measures such as the left atrial emptying fraction (LAEF) and the minimal LA volume compared with left atrial volume index (LAVI) in HFrEF patients.

Methods And Results: A total of 818 HFrEF patients with left ventricular ejection fractions <45% underwent echocardiography.

Burden of Uncontrolled Metabolic Risk Factors and Left Ventricular Structure and Function in Patients With Type 2 Diabetes Mellitus.

Background Type 2 diabetes mellitus is closely associated with metabolic risk factors that all contribute to impairment of the left ventricle. The implications of having type 2 diabetes mellitus with well-controlled metabolic risk factors compared to an increasing burden of uncontrolled metabolic risk factors on left ventricular structure and function are not known. Methods and Results We compared patients with type 2 diabetes mellitus (n=751) with different degrees of uncontrolled metabolic risk factors present with a control group of individuals without present uncontrolled metabolic risk factors as recommended by the World Health Organization (n=80).

Prognostic Importance of Left Ventricular Mechanical Dyssynchrony in Predicting Cardiovascular Death in the General Population.

Background: Cardiovascular death (CVD) is a leading cause of death and constitutes a major burden on society. Left ventricular mechanical dyssynchrony (LVMD), evaluated as SD of time to peak regional longitudinal strain, is a capable predictor of many cardiovascular outcomes related to CVD, including ventricular arrhythmias, but the prognostic utility of LVMD in the general population is unknown. Hence, this study sought to determine the prognostic value of LVMD in the general population in predicting CVD.

Post-systolic shortening: normal values and association with validated echocardiographic and invasive measures of cardiac function.

Post-systolic shortening (PSS) does not contribute to the ejection of blood and may inhibit diastolic filling. We determined normal values of PSS in healthy subjects and investigated associations with echocardiographic and invasive measures of systolic and diastolic function. We prospectively analyzed participants from the general population (n = 620, mean age 47 ± 14 years) with no cardiovascular disease.

[Heart failure often accompanies diabetes mellitus].

There are 320,000 diabetes patients in Denmark. Heart failure (HF) is a major cardiovascular complication to diabetes mellitus with increasing prevalence. HF occurs 2-4 times more frequently in diabetes patients, but patients may go undiagnosed for years.

Usefulness of Postsystolic Shortening to Diagnose Coronary Artery Disease and Predict Future Cardiovascular Events in Stable Angina Pectoris.

Background: Postsystolic shortening (PSS) may occur during myocardial ischemia. We aimed to assess the diagnostic and prognostic potential of PSS in patients with suspected stable angina pectoris (SAP).

Methods: This is a prospective study of patients with suspected SAP (N = 293), no prior cardiac history, and normal ejection fraction, who were examined by speckle-tracking echocardiography, coronary angiography, and exercise electrocardiogram.

Type 1 diabetes is associated with T-wave morphology changes. The Thousand & 1 Study.

Background: Repolarization is impaired in patients with type 1 diabetes mellitus (T1DM), and repolarization disturbances are associated with an increased mortality. To study cardiac repolarization, we assessed T-wave morphology in patients with T1DM without known heart disease.

Methods: 855 T1DM patients without known heart disease were matched 1:2 with 1710 people from a background population.

Global longitudinal strain corrected by RR-interval is a superior echocardiographic predictor of outcome in patients with atrial fibrillation.

Background: Echocardiographic assessment of systolic and diastolic function during atrial fibrillation (AF) is challenging. This study evaluates the prognostic value of strain in patients with AF and suggests a novel approach on how to take into account the varying heart cycle lengths in AF.

Methods: Echocardiograms from 204 patients with AF during examination were analyzed offline.

Measures of left atrial function predict incident atrial fibrillation in STEMI patients treated with primary percutaneous coronary intervention.

Rationale: Atrial fibrillation (AF) is the most common arrhythmia following acute myocardial infarction (AMI). Maximal left atrial (LA) volume is the only echocardiographic atrial parameter employed clinically to assess risk of AF development.

Objective: This study sought to determine the prognostic value of left atrial functional measures such as left atrial emptying fraction (LAEF) and left atrial expansion index (LAi) in predicting incident AF in the post-STEMI setting.

Ratio of transmitral early filling velocity to early diastolic strain rate predicts long-term risk of cardiovascular morbidity and mortality in the general population.

Aims: It has previously been demonstrated that the ratio of early mitral inflow velocity to global diastolic strain rate (E/e'sr) is a significant predictor of cardiac events in specific patient populations. The utility of this measurement to predict cardiovascular events in a general population has not been evaluated.

Methods And Results: A total of 1238 participants in a general population study underwent a health examination including echocardiography where global longitudinal strain (GLS) and E/e'sr were determined.

Association between layer-specific global longitudinal strain and adverse outcomes following acute coronary syndrome.

Aims: To investigate the prognostic value of layer-specific global longitudinal strain (GLS) in predicting heart failure (HF) and cardiovascular death (CD) following acute coronary syndrome (ACS).

Methods And Results: In this retrospective study, 465 ACS patients underwent transthoracic echocardiography following percutaneous coronary intervention (PCI). The primary endpoint was the composite of HF and/or CD with a median follow-up time of 4.

Postsystolic Shortening by Speckle Tracking Echocardiography Is an Independent Predictor of Cardiovascular Events and Mortality in the General Population.

Background: Postsystolic shortening (PSS) has been proposed as a novel marker of contractile dysfunction in the myocardium. Our objective was to assess the prognostic potential of PSS on cardiovascular events and death in the general population.

Methods And Results: The study design consisted of a prospective cohort study of 1296 low-risk participants from the general population, who were examined by speckle tracking echocardiography.

Prognostic Value of Echocardiography in Hypertensive Versus Nonhypertensive Participants From the General Population.

Hypertension may be the most significant cardiovascular risk factor. Few studies have assessed the prognostic value of echocardiography in hypertensive individuals. This study examines the incremental prognostic value of adding echocardiographic parameters to established risk factors in individuals from the general population with and without hypertension.

Presence of post-systolic shortening is an independent predictor of heart failure in patients following ST-segment elevation myocardial infarction.

Following an ischemic event post systolic shortening (PSS) may occur. We investigated the association between PSS in patients with ST-segment elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI) and occurrence of cardiovascular events at follow-up. A total of 373 patients admitted with STEMI and treated with pPCI were prospectively included in the study cohort.

Impact of transducer frequency setting on speckle tracking measures.

Speckle tracking echocardiography is an emerging technique, which is currently being included in clinical guidelines. We sought to investigate the impact of transducer frequency settings on speckle tracking derived measures. The study comprised of 22 subjects prospectively enrolled for a randomized controlled trial (LOOP-study, Clinicaltrials.

Presence of micro- and macroalbuminuria and the association with cardiac mechanics in patients with type 2 diabetes.

Aims: Albuminuria-a marker of generalized vascular dysfunction-is a strong predictor of heart failure in patients with type 2 diabetes which may be caused by concomitant myocardial dysfunction reflecting the same underlying pathogenesis.

Methods And Results: We included 915 patients with type 2 diabetes from two secondary care centres and stratified according to albuminuria status in normo-, micro-, and macroalbuminuria. We performed comprehensive echocardiography including conventional imaging, tissue Doppler imaging, and 2D speckle tracking.

Global longitudinal strain corrected by RR interval is a superior predictor of all-cause mortality in patients with systolic heart failure and atrial fibrillation.

Aims: Quantification of systolic function in patients with atrial fibrillation (AF) is challenging. A novel approach, based on RR interval correction, to counteract the varying heart cycle lengths in AF has recently been proposed. Whether this method is superior in patients with systolic heart failure (HFrEF) with AF remains unknown.