Wall motion abnormalities up risk of heart failure

Global wall motion score index (WMSI), as well as abnormalities in any of the left ventricular (LV) regional walls, is associated with the risk of incident heart failure (HF), reports a new study.

Researchers enrolled 3,415 general population participants (mean age 58 years, 42 percent men) who were free from HF or ischaemic heart disease at baseline. WMSI was measured through echocardiography, obtaining assessments for the anterior, lateral, inferior, septal, and posterior LV walls. Incident HF was the primary endpoint.

Eighty-three participants (2.4 percent) were found to have abnormalities in at least one LV wall segment at baseline. These included hypokinetic, akinetic, or dyskinetic segments, determined through a WMSI value ≥2. The median WMSI was 1.25 in participants who showed such abnormalities. Over a median follow-up of 15.4 years, 8.7 percent (n=297) of participants developed incident HF.  

Cox regression analysis showed that global WMSI was a significant risk factor for incident HF (hazard ratio [HR] per 0.1-unit increase, 1.38, 95 percent confidence interval [CI], 1.22–1.56; p<0.001). The same was true for WM abnormalities in any LV wall (HR, 3.63, 95 percent CI, 2.15–6.12; p<0.001).

In particular, abnormalities in the anterior (HR, 5.02, 95 percent CI, 2.26–11.14; p<0.001), septal (HR, 3.76, 95 percent CI, 1.98–7.15; p<0.001), lateral (HR, 2.75, 95 percent CI, 1.24–6.08; p=0.013), inferior (HR, 4.37, 95 percent CI, 2.36–8.08; p<0.001), and posterior (HR, 3.36, 95 percent CI, 1.66–7.99; p=0.001) LV walls significantly increased HF likelihood.