Predictors of hypercontractile heart phenotype in patients with chronic coronary syndromes or heart failure

Predictors of hypercontractile heart phenotype in patients with chronic coronary syndromes or heart failure | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictors of hypercontractile heart phenotype in patients with chronic coronary syndromes or heart failure Yi Wang, Quirino Ciampi, Lauro Cortigiani, Angela Zagatina, Jaroslaw D. Kasprzak, and 26 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4476811/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 10 Oct, 2024 Read the published version in The International Journal of Cardiovascular Imaging → Version 1 posted 11 You are reading this latest preprint version Abstract Background Hypercontractile phenotype (HP) of the left ventricle (LV) is an actionable therapeutic target in patients with chronic coronary syndromes (CCS) or heart failure (HF), but its clinical recognition remains difficult. Objectives To assess the clinical variables associated with the HP. Methods In a prospective, observational, multicenter study, we recruited 5,122 patients (age 65 ± 11 years, 2974 males, 58%) with CCS and/or HF with preserved ejection fraction (EF). Systolic blood pressure (SBP) was measured. We assessed wall motion score index (WMSI), LV end-diastolic volume (EDV), end-systolic volume (ESV), EF, force (SBP/ESV), stroke volume (SV), arterial elastance (SBP/SV), and ventricular-arterial coupling (VAC, as SV/ESV). Univariable and multivariable logistic regression analysis assessed independent factors associated with the highest force sextile. Results For all the studied patients, force was 4.51 ± 2.11 mmHg/ml, with the highest sextile (Group 6) > 6.36 mmHg/ml. By multivariable logistic regression model, the highest sextile of force was associated with age > 65 years (OR 1.62, 95% CI 1.36–1.93, p < 0.001), hypertension (OR 1.76, 95% CI 1.40–2.21, p < 0.001), female sex (OR 4.52, 95% CI 3.77–5.42, p < 0.001), absence of beta-blocker therapy (OR 1.41, 95% CI 1.16–1.68), rest SBP ≥ 160 mmHg (OR 2.81, 95% CI 2.21–3.56, p < 0.001), high heart rate (OR 2.08, 95% CI 1.61–2.67, p < 0.001), and absence of prior myocardial infarction (OR 1.34, 95% CI 1.07–1.68, p = 0.012). Patients in the highest sextile of force showed lower values of WMSI, SV, EDV, and ESV, and higher values of arterial elastance and VAC. Conclusions HP of the LV with high force was clinically associated with advanced age, female sex, high resting SBP, and the absence of 𝛽-blocker therapy. By transthoracic echocardiography, HP was associated with a small heart with reduced EDV, reduced SV despite high EF, and higher arterial elastance. Echocardiography Hyperfunction Left ventricle Phenotype systolic function Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementarymaterialAppendixStressecho2030studygroupandrecruimentcenter.docx Cite Share Download PDF Status: Published Journal Publication published 10 Oct, 2024 Read the published version in The International Journal of Cardiovascular Imaging → Version 1 posted Editorial decision: Revision requested 09 Aug, 2024 Reviews received at journal 31 Jul, 2024 Reviewers agreed at journal 22 Jul, 2024 Reviewers agreed at journal 15 Jul, 2024 Reviews received at journal 07 Jun, 2024 Reviewers agreed at journal 28 May, 2024 Reviewers agreed at journal 28 May, 2024 Reviewers invited by journal 28 May, 2024 Submission checks completed at journal 25 May, 2024 Editor assigned by journal 25 May, 2024 First submitted to journal 25 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4476811","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":311880450,"identity":"7d31c5a4-5204-4da0-b126-9b42256f99a0","order_by":0,"name":"Yi Wang","email":"","orcid":"","institution":"Sichuan Academy of Medical Sciences \u0026 Sichuan Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yi","middleName":"","lastName":"Wang","suffix":""},{"id":311880452,"identity":"65039577-7911-4811-8fdd-f57411082673","order_by":1,"name":"Quirino Ciampi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAu0lEQVRIiWNgGAWjYFACxgYgISEHYh54wCBBvBZjsJYEBgmi9IBBIkgjQwIDEdbwHT/c+OnmDov0+WGHHwJtsagjqEXyTGKzdO4ZidyNt9MMiHOYwQ3GBuncNqCW2QnEa2n+DdSSbjg7/QPRWtpAtiTIS+cQaQvQL23WQL8YbpDOKTiQYCAh2UBIC9/x449v5+6ok5efnb75w4eKOn6CtjAcYIDEpsEBsDsJa0BokSfooFEwCkbBKBixAAAp2z7ZuktwRgAAAABJRU5ErkJggg==","orcid":"","institution":"Fatebenefratelli Hospital","correspondingAuthor":true,"prefix":"","firstName":"Quirino","middleName":"","lastName":"Ciampi","suffix":""},{"id":311880456,"identity":"274c5ef7-d92a-4554-8594-9c1f49c5f597","order_by":2,"name":"Lauro Cortigiani","email":"","orcid":"","institution":"San Luca Hospital","correspondingAuthor":false,"prefix":"","firstName":"Lauro","middleName":"","lastName":"Cortigiani","suffix":""},{"id":311880457,"identity":"6aa67b20-b4ee-42e6-b0a5-e24fb1cd7aea","order_by":3,"name":"Angela Zagatina","email":"","orcid":"","institution":"Research Scientific Cardiocenter “Medika”","correspondingAuthor":false,"prefix":"","firstName":"Angela","middleName":"","lastName":"Zagatina","suffix":""},{"id":311880458,"identity":"bb7d2992-c513-4fd0-8c51-a57feaafb583","order_by":4,"name":"Jaroslaw D. 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Systolic blood pressure (SBP) was measured. We assessed wall motion score index (WMSI), LV end-diastolic volume (EDV), end-systolic volume (ESV), EF, force (SBP/ESV), stroke volume (SV), arterial elastance (SBP/SV), and ventricular-arterial coupling (VAC, as SV/ESV). Univariable and multivariable logistic regression analysis assessed independent factors associated with the highest force sextile.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFor all the studied patients, force was 4.51\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11 mmHg/ml, with the highest sextile (Group 6)\u0026thinsp;\u0026gt;\u0026thinsp;6.36 mmHg/ml. By multivariable logistic regression model, the highest sextile of force was associated with age\u0026thinsp;\u0026gt;\u0026thinsp;65 years (OR 1.62, 95% CI 1.36\u0026ndash;1.93, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), hypertension (OR 1.76, 95% CI 1.40\u0026ndash;2.21, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), female sex (OR 4.52, 95% CI 3.77\u0026ndash;5.42, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), absence of beta-blocker therapy (OR 1.41, 95% CI 1.16\u0026ndash;1.68), rest SBP\u0026thinsp;\u0026ge;\u0026thinsp;160 mmHg (OR 2.81, 95% CI 2.21\u0026ndash;3.56, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), high heart rate (OR 2.08, 95% CI 1.61\u0026ndash;2.67, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and absence of prior myocardial infarction (OR 1.34, 95% CI 1.07\u0026ndash;1.68, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.012). Patients in the highest sextile of force showed lower values of WMSI, SV, EDV, and ESV, and higher values of arterial elastance and VAC.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eHP of the LV with high force was clinically associated with advanced age, female sex, high resting SBP, and the absence of \u0026#120573;-blocker therapy. By transthoracic echocardiography, HP was associated with a small heart with reduced EDV, reduced SV despite high EF, and higher arterial elastance.\u003c/p\u003e","manuscriptTitle":"Predictors of hypercontractile heart phenotype in patients with chronic coronary syndromes or heart failure","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-10 16:07:48","doi":"10.21203/rs.3.rs-4476811/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-09T18:48:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-31T20:25:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"5671287264507278105520831643174352177","date":"2024-07-22T19:43:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"279823477431213777916544110895629640303","date":"2024-07-15T14:48:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-07T16:32:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"165988410477984999189737237574436577803","date":"2024-05-28T11:40:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"143788557815821397429698177721101447039","date":"2024-05-28T10:26:44+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-28T09:43:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-25T15:39:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-25T15:39:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"The International Journal of Cardiovascular Imaging","date":"2024-05-25T12:39:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"the-international-journal-of-cardiovascular-imaging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"caim","sideBox":"Learn more about [The International Journal of Cardiovascular Imaging](https://www.springer.com/journal/10554)","snPcode":"10554","submissionUrl":"https://submission.nature.com/new-submission/10554/3","title":"The International Journal of Cardiovascular Imaging","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4eaa08e9-afbc-4a7b-93fb-13632ced5133","owner":[],"postedDate":"June 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-10-14T16:08:24+00:00","versionOfRecord":{"articleIdentity":"rs-4476811","link":"https://doi.org/10.1007/s10554-024-03240-6","journal":{"identity":"the-international-journal-of-cardiovascular-imaging","isVorOnly":false,"title":"The International Journal of Cardiovascular Imaging"},"publishedOn":"2024-10-10 15:57:04","publishedOnDateReadable":"October 10th, 2024"},"versionCreatedAt":"2024-06-10 16:07:48","video":"","vorDoi":"10.1007/s10554-024-03240-6","vorDoiUrl":"https://doi.org/10.1007/s10554-024-03240-6","workflowStages":[]},"version":"v1","identity":"rs-4476811","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4476811","identity":"rs-4476811","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}