@article{SahitiMorbachCejkaetal.2022,
  author    = {Sahiti, Floran and Morbach, Caroline and Cejka, Vladimir and Tiffe, Theresa and Wagner, Martin and Eichner, Felizitas A. and Gelbrich, G{\"o}tz and Heuschmann, Peter U. and St{\"o}rk, Stefan},
  title     = {Impact of cardiovascular risk factors on myocardial work-insights from the STAAB cohort study},
  series = {Journal of Human Hypertension},
  volume    = {36},
  journal   = {Journal of Human Hypertension},
  number    = {3},
  issn      = {1476-5527},
  doi       = {10.1038/s41371-021-00509-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-271770},
  pages     = {235-245},
  year      = {2022},
  abstract  = {Myocardial work is a new echocardiography-based diagnostic tool, which allows to quantify left ventricular performance based on pressure-strain loops, and has been validated against invasively derived pressure-volume measurements. Myocardial work is described by its components (global constructive work [GCW], global wasted work [GWW]) and indices (global work index [GWI], global work efficiency [GWE]). Applying this innovative concept, we characterized the prevalence and severity of subclinical left ventricular compromise in the general population and estimated its association with cardiovascular (CV) risk factors. Within the Characteristics and Course of Heart Failure STAges A/B and Determinants of Progression (STAAB) cohort study we comprehensively phenotyped a representative sample of the population of W{\"u}rzburg, Germany, aged 30-79 years. Indices of myocardial work were determined in 1929 individuals (49.3\% female, mean age 54 ± 12 years). In multivariable analysis, hypertension was associated with a mild increase in GCW, but a profound increase in GWW, resulting in higher GWI and lower GWE. All other CV risk factors were associated with lower GCW and GWI, but not with GWW. The association of hypertension and obesity with GWI was stronger in women. We conclude that traditional CV risk factors impact selectively and gender-specifically on left ventricular myocardial performance, independent of systolic blood pressure. Quantifying active systolic and diastolic compromise by derivation of myocardial work advances our understanding of pathophysiological processes in health and cardiac disease.},
  language  = {en}
}
@article{SahitiMorbachCejkaetal.2021,
  author    = {Sahiti, Floran and Morbach, Caroline and Cejka, Vladimir and Albert, Judith and Eichner, Felizitas A. and Gelbrich, G{\"o}tz and Heuschmann, Peter U. and St{\"o}rk, Stefan},
  title     = {Left Ventricular Remodeling and Myocardial Work: Results From the Population-Based STAAB Cohort Study},
  series = {Frontiers in Cardiovascular Medicine},
  volume    = {8},
  journal   = {Frontiers in Cardiovascular Medicine},
  issn      = {2297-055X},
  doi       = {10.3389/fcvm.2021.669335},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-240480},
  year      = {2021},
  abstract  = {Introduction: Left ventricular (LV) dilatation and LV hypertrophy are acknowledged precursors of myocardial dysfunction and ultimately of heart failure, but the implications of abnormal LV geometry on myocardial function are not well-understood. Non-invasive LV myocardial work (MyW) assessment based on echocardiography-derived pressure-strain loops offers the opportunity to study detailed myocardial function in larger cohorts. We aimed to assess the relationship of LV geometry with MyW indices in general population free from heart failure. Methods and Results: We report cross-sectional baseline data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of the general population of W{\"u}rzburg, Germany, aged 30-79 years. MyW analysis was performed in 1,926 individuals who were in sinus rhythm and free from valvular disease (49.3\% female, 54 ± 12 years). In multivariable regression, higher LV volume was associated with higher global wasted work (GWW) (+0.5 mmHg\% per mL/m\(^2\), p < 0.001) and lower global work efficiency (GWE) (-0.02\% per mL/m\(^2\), p < 0.01), while higher LV mass was associated with higher GWW (+0.45 mmHg\% per g/m\(^2\), p < 0.001) and global constructive work (GCW) (+2.05 mmHg\% per g/m\(^2\), p < 0.01) and lower GWE (-0.015\% per g/m\(^2\), p < 0.001). This was dominated by the blood pressure level and also observed in participants with normal LV geometry and concomitant hypertension. Conclusion: Abnormal LV geometric profiles were associated with a higher amount of wasted work, which translated into reduced work efficiency. The pattern of a disproportionate increase in GWW with higher LV mass might be an early sign of hypertensive heart disease.},
  language  = {en}
}