HypertensionCohort study
Relationship of Subendocardial Perfusion to Myocardial Injury, Cardiac Structure, and Clinical Outcomes Among Patients With Hypertension
- Retrospective cohort study
- post hoc observational
- single-centre
Authors' conclusion
Among patients with hypertension without flow-limiting coronary artery disease, impaired MFRsubendo was associated with cardiovascular risk factors, elevated cardiac biomarkers, cardiac structure, and clinical events.
Study context
- Population
- Consecutive patients with hypertension without flow-limiting CAD (summed stress score <3), 13N-ammonia PET at Brigham and Women's Hospital, 2015–2021
- Participants
- 358 patients
- Exposure
- Lowest vs highest tertile of subendocardial myocardial flow reserve (MFR)
- Outcome
- MACCE:
- Death
- HF hospitalization
- MI
- Stroke
- Follow-up
- Median 1.1 (IQR 0.6-2.8) years
Main finding
MACCE · median 1.1 years
Adjusted hazard ratio
2.99
95% CI 1.39–6.44
P = 0.005
Lowest tertile vs Highest tertile
adjusted HR 2.99 (95% CI 1.39–6.44); P = 0.005
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| HF hospitalization · median 1.1 years | 2.76 (1.04–7.32) | P = 0.042 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
MFRsubendo (whole cohort)
- Median MFRsubendo, IQR 2.08-3.10
- 2.57
Myocardial injury and cardiac structure
- Lowest tertile associated with myocardial injury and greater LV wall thickness and volumes vs highest tertile (cross-sectional multivariable)
Original publication
Relationship of Subendocardial Perfusion to Myocardial Injury, Cardiac Structure, and Clinical Outcomes Among Patients With Hypertension. Circulation. Published 21 August 2024. doi:10.1161/circulationaha.123.067083
Summarised from the published abstract; every number is checked against it