Influencing Factors for Subendocardial Viability Ratio in the Community Population

Abstract

Background At present, cardiovascular diseases still have a high incidence and mortality worldwide. Subendocardial viability ratio (SEVR) is calculated from the analysis of left ventricular and aortic pressure curves in invasive hemodynamic studies, serving as a valuable indicator of myocardial perfusion, and predictive factor for cardiovascular adverse events and mortality in different populations. Although having certain limitations, non-invasive measurements of SEVR are valuable tools for evaluating myocardial perfusion and assessing cardiovascular risk. However, large-scale epidemiological studies to explore the practical value of SEVR in primary and secondary prevention of cardiovascular diseases are scant. Objective This study aims to non-invasively measure SEVR in a large-scale Beijing community-based population and to identify the influencing factors. Methods It was a cross-sectional follow-up study involving a cohort of residents (≥40 years of age) with atherosclerosis in the Shougang Community, Shijingshan District, Beijing, who were treated in the Department of Cardiology, Peking University First Hospital from December 2011 to April 2012. Non-invasive SEVR measurements were conducted using Pulsepen (DiaTecne srl, San Donato Milanese, Italy) during the follow-up period in 2018. Generalized linear regression models were applied to analyze influencing factors for SEVR. Results A total of 6 568 participants followed up in 2018 were initially enrolled. After excluding those without SEVR data for arrhythmia (2.8%), 6 382 eligible ones were finally included in our study. SEVR measurements were obtained from 97.2% of patients. In the cohort, there were 2 130 males and 4 252 females, with a mean SEVR of (144±22) %. The Multivariate linear regression analysis showed that sex (β=-11.00), age (β=-0.53), smoking (β=2.36), hypertension (β=-4.12), dyslipidemia (β=-1.45), diabetes (β=-4.36), antihypertensive drugs (β=3.72), and hypoglycemic treatment (β=-3.71) were independently associated with SEVR (P<0.05). In males, age (β=-0.67), hypertension (β=-3.20), dyslipidemia (β=-2.73), diabetes (β=-3.42), and hypoglycemic treatment (β=-5.07) were independent influencing factors for SEVR (P<0.05). In females, age (β=-0.48), smoking (β=9.44), hypertension (β=-4.98), diabetes (β=-4.95), antihypertensive drugs (β=5.26), and hypoglycemic treatment (β=-2.82) were independent influencing factors for SEVR (P<0.05) . Conclusion Non-invasive measurement of SEVR is feasible in large-scale community-based populations. SEVR is associated with traditional risk factors, such as sex, age, smoking, hypertension, dyslipidemia, and diabetes. The relationship between SEVR and medication needs to be explored through further research.

Keywords

• subendocardial viability ratio|atherosclerosis|community population|cohort study|root cause analysis