title: The prognostic value of early left ventricular longitudinal systolic dysfunction in asymptomatic subjects with cardiovascular risk factors.
abstract: BACKGROUND
  Early diagnosis of left ventricular (LV) dysfunction represents a major challenge in asymptomatic subjects with cardiovascular (CV) risk factors. Tissue Doppler imaging (TDI) has emerged as an important tool with clinical relevance in several cardiac diseases.
  
  
  OBJECTIVE
  To evaluate the prognostic ability of TDI in detecting early longitudinal ventricular dysfunction in a large group of asymptomatic subjects with CV risk factors (RsF), normal LV systolic function, and normal diastolic function.
  
  
  METHODS
  A total of 554 subjects (mean age 55 ± 13 years, 39% men) formed our study population: controls, 144 healthy subjects; group 1, 163 subjects with 1 CV RsF; group 2, 147 subjects with 2 CV RsF; group 3, 100 subjects with ≥3 CV RsF. All subjects underwent a comprehensive standard echo-Doppler evaluation, including posterior wall TDI study. Follow-up data were available in all the studied samples (mean 28 ± 16 mo).
  
  
  RESULTS
  Upon follow-up, 18 individuals (3.2%) developed a first overt CV event. The presence of a peak systolic velocity <7.5 cm/second showed a significant additional predictive value compared with the presence of CV RsF (P<0.001).
  
  
  CONCLUSIONS
  Tissue Doppler imaging is able to identify early longitudinal LV systolic abnormalities in the presence of apparently normal systolic and diastolic function. It demonstrated a significant additional prognostic value compared with the simple presence of coexisting CV RsF. These findings could be clinically relevant in identifying asymptomatic subjects with CV RsF who need early, tailored preventive treatment.
authors.affiliation: Department of Cardiology, Second University of Naples, Naples. giodisal@yahoo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.forename: Alessandro
authors.initials: A
authors.lastname: Salustri
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonini-Canterin
authors.forename: Salvatore
authors.initials: S
authors.lastname: La Carrubba
authors.forename: Carlo
authors.initials: C
authors.lastname: Materazzo
authors.forename: Luigi
authors.initials: L
authors.lastname: Badano
authors.forename: Pio
authors.initials: P
authors.lastname: Caso
authors.forename: Antonio
authors.initials: A
authors.lastname: Pezzano
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.forename: Scipione
authors.initials: S
authors.lastname: Carerj
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D003971:Diastole; D042241:Early Diagnosis; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left