Identification of echocardiographic subgroups in patients with coronary heart disease combined with heart failure based on latent variable stratification. (15th February 2023)

• Record Type: Journal Article
• Authors: Du, Yutao; Yuan, Na; Yan, Jingjing; Han, Gangfei; Hu, Xiaojuan; Zhang, Yanbo; Tian, Jing
• Is Part Of: International journal of cardiology. Volume 373(2023)
• Page Start: 90
• Page End: 98
• Publication Date: 2023-02-15
• Subjects: Chronic heart failure -- Echocardiography -- Latent class analysis; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.11.038
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The prognosis of chronic heart failure is poor, and it remains a challenge to classify patients for better personalized intervention. This study aimed to explore potential subgroups in patients with coronary heart disease and chronic heart failure using comprehensive echocardiographic indices. Methods: 5126 patients with coronary heart disease with chronic heart failure were included. Latent class analysis was applied to identify the grouping patterns of patients based on echocardiographic indices. Network maps and radar charts of echocardiographic indices were drawn to visualize the distribution of echocardiographic findings. The incidence of adverse outcomes was presented on the Kaplan–Meier curve and compared using the log-rank test. The Cox regression model was used to analyze the relationship between subgroups and mortality. Results: Three groups were identified: eccentric hypertrophy, concentric hypertrophy, and decreased diastolic function. Network plots showed a higher correlation between left atrial diameter, left ventricular mass index, and left ventricle ejection fraction in the eccentric hypertrophy group than in the other groups. The Kaplan-Meier curve showed a significant difference in mortality between the three subgroups ( P < 0.001). Multivariate Cox analysis indicated that the eccentric hypertrophy group had the highest risk of death (HR = 1.586, 95% CI: 1.310–1.921, P < 0.001) compared with the other groups. Conclusion: Patients with coronary heart disease and chronic heart failure can be classified into three subgroups based on echocardiographic indices. This grouping has been shown to be an independent risk factor for mortality in these patients. Accurate subgrouping based on echocardiographic indices is important for identifying high-risk patients. Highlights: CHD is strongly associated with risk of mortality in patients with CHF. CHF patients can be divided 3 groups based on echocardiographic indices using LCA. This grouping is an independent risk factor for mortality in CHF patients. This grouping is important for identifying high-risk patients.