Influencing Factors for Subendocardial Viability Ratio in the Community Population postprint

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 of 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 Multivariable 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.