{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:26:09Z","timestamp":1793179569130,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100007405","name":"Danish Heart Foundation","doi-asserted-by":"publisher","award":["NNF20SA0067242"],"award-info":[{"award-number":["NNF20SA0067242"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Metropolitan Region of Denmark"},{"name":"Danish Cardiovascular Academy"},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Left ventricular (LV) systolic deformation is altered early in the ventricular disease process despite normal LV ejection fraction (LVEF). These alterations seem to be characterized by decreased global longitudinal strain (GLS) and augmented global circumferential strain (GCS). This study aimed to investigate the link between myocardial deformation phenotyping using longitudinal and circumferential strain and risk of incident heart failure (HF) and cardiovascular death (CD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The study sample was based on the prospective cohort study the 5th Copenhagen City Heart Study (2011\u201315). All participants were examined with echocardiography following a pre-defined protocol. A total of 2874 participants were included. Mean age was 53\u00b118 years and 60% were female. During a median follow-up of 3.5 years, a total of 73 developed HF\/CD. A U-shaped relationship between GCS and HF\/CD was observed. LVEF significantly modified the association between GCS and HF\/CD (P for interaction &amp;lt;0.001). The optimal transition point for the effect modification was LVEF &amp;lt; 50%. In multivariable Cox regressions, increasing GCS was significantly associated with HF\/CD in participants with LVEF \u2265 50% (hazard ratio [HR]=1.12 [95% confidence interval (CI): 1.02; 1.23] per 1% increase), while decreasing GCS was associated with a higher risk of HF\/CD in individuals with LVEF &amp;lt; 50% [HR=1.18 (95% CI: 1.05; 1.31) per 1% decrease].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The prognostic utility of GCS is modified by LVEF. In participants with normal LVEF, higher GCS was associated with increased risk of HF\/CD, while the opposite was observed in participants with abnormal LVEF. This observation adds important information to our understanding of the pathophysiological evolution of myocardial deformation in cardiac disease progression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead075","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T18:47:32Z","timestamp":1682016452000},"page":"999-1006","source":"Crossref","is-referenced-by-count":17,"title":["Link between myocardial deformation phenotyping using longitudinal and circumferential strain and risk of incident heart failure and cardiovascular death"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2690-7511","authenticated-orcid":false,"given":"Kristoffer Grundtvig","family":"Skaarup","sequence":"first","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2255-582X","authenticated-orcid":false,"given":"Mats Christian H\u00f8jbjerg","family":"Lassen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6959-3236","authenticated-orcid":false,"given":"Niklas Dyrby","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Sengel\u00f8v","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming Javier","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorm Boje","family":"Jensen","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schnohr","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amil","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , 75 Francis St, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Lee","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , 75 Francis St, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , 75 Francis St, Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"M\u00f8gelvang","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"},{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet , Blegdamsvej 9, DK-2100 Copenhagen , Denmark"},{"name":"Cardiovascular Research Unit, University of Southern Denmark , Campusvej 55, DK-5230 Odense M , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4209-2778","authenticated-orcid":false,"given":"Tor","family":"Biering-S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2014Herlev and Gentofte , Kildeg\u00e5rdsvej 28, DK-2900, Post 835, Copenhagen , Denmark"},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg , Nordre Fasanvej 57, DK-2000 Frederiksberg , Denmark"},{"name":"Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3B, DK-2200 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"2023072413340565900_jead075-B1","first-page":"260","article-title":"Assessment of left ventricular function by echocardiography: the case for routinely adding global longitudinal strain to ejection fraction","volume":"11","author":"Potter","year":"2018","journal-title":"JACC: Cardiovascular Imaging"},{"key":"2023072413340565900_jead075-B2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.amjcard.2008.02.101","article-title":"Association of myocardial strain with left ventricular geometry and progression of hypertensive heart disease","volume":"102","author":"Hare","year":"2008","journal-title":"Am J Cardiol"},{"key":"2023072413340565900_jead075-B3","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1093\/eurheartj\/ehv529","article-title":"Myocardial strain imaging: how useful is it in clinical decision making?","volume":"37","author":"Smiseth","year":"2016","journal-title":"Eur Heart J"},{"key":"2023072413340565900_jead075-B4","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.echo.2008.07.016","article-title":"The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with two-dimensional strain imaging","volume":"21","author":"Mizuguchi","year":"2008","journal-title":"J Am Soc Echocardiogr"},{"key":"2023072413340565900_jead075-B5","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.ahj.2009.07.008","article-title":"Differential effects of afterload on left ventricular long- and short-axis function: insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement","volume":"158","author":"Carasso","year":"2009","journal-title":"Am Heart J"},{"key":"2023072413340565900_jead075-B6","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.echo.2006.10.013","article-title":"Left ventricular form and function revisited: applied translational science to cardiovascular ultrasound imaging","volume":"20","author":"Sengupta","year":"2007","journal-title":"J Am Soc Echocardiogr"},{"key":"2023072413340565900_jead075-B7","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.116.005521","article-title":"Global longitudinal strain by echocardiography predicts long-term risk of cardiovascular morbidity and mortality in a low-risk general population: the Copenhagen City Heart Study","volume":"10","author":"Biering-S\u00f8rensen","year":"2017","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B8","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1161\/CIRCULATIONAHA.116.023361","article-title":"Heart failure stages among older adults in the community: the Atherosclerosis Risk in Communities Study","volume":"135","author":"Shah","year":"2017","journal-title":"Circulation"},{"key":"2023072413340565900_jead075-B9","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.002071","article-title":"Distinct aspects of left ventricular mechanical function are differentially associated with cardiovascular outcomes and all-cause mortality in the community","volume":"4","author":"Cheng","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2023072413340565900_jead075-B10","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/ejhf.154","article-title":"Prevalence and prognostic value of subclinical left ventricular systolic dysfunction by global longitudinal strain in a community-based cohort","volume":"16","author":"Russo","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2023072413340565900_jead075-B11","doi-asserted-by":"crossref","first-page":"3081","DOI":"10.1161\/01.CIR.0000147184.13872.0F","article-title":"Alterations of left ventricular myocardial characteristics associated with obesity","volume":"110","author":"Wong","year":"2004","journal-title":"Circulation"},{"key":"2023072413340565900_jead075-B12","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.ahj.2006.12.025","article-title":"Regional left ventricular function in individuals with mild to moderate renal insufficiency: the Multi-Ethnic Study of Atherosclerosis","volume":"153","author":"Nasir","year":"2007","journal-title":"Am Heart J"},{"key":"2023072413340565900_jead075-B13","article-title":"Additive prognostic value of echocardiographic global longitudinal and global circumferential strain to electrocardiographic criteria in patients with heart failure undergoing cardiac resynchronization therapy","volume":"9","author":"Delgado-Montero","year":"2016","journal-title":"Circulation: Cardiovascular Imaging"},{"key":"2023072413340565900_jead075-B14","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jjcc.2013.05.001","article-title":"Prognostic value of global left ventricular strain for conservatively treated patients with symptomatic aortic stenosis","volume":"62","author":"Lee","year":"2013","journal-title":"J Cardiol"},{"key":"2023072413340565900_jead075-B15","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.ijcard.2016.08.277","article-title":"Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome: compared with syntax score","volume":"223","author":"Zhang","year":"2016","journal-title":"Int J Cardiol"},{"key":"2023072413340565900_jead075-B16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/ejechocard\/jer172","article-title":"Torsion analysis in the early detection of anthracycline-mediated cardiomyopathy","volume":"13","author":"Motoki","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B17","doi-asserted-by":"crossref","first-page":"33","DOI":"10.5339\/gcsp.2015.33","article-title":"The Copenhagen City Heart Study (\u00d8sterbrounders\u00f8gelsen)","volume":"2015","author":"Aguib","year":"2015","journal-title":"Glob Cardiol Sci Pract"},{"key":"2023072413340565900_jead075-B18","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1093\/ehjci\/jeab032","article-title":"Age- and sex-based normal values of layer-specific longitudinal and circumferential strain by speckle tracking echocardiography: the Copenhagen City Heart Study","volume":"23","author":"Skaarup","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B19","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1471-2288-11-83","article-title":"The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients","volume":"11","author":"Thygesen","year":"2011","journal-title":"BMC Med Res Methodol"},{"key":"2023072413340565900_jead075-B20","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B21","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1161\/01.RES.24.3.339","article-title":"Fiber orientation in the canine left ventricle during diastole and systole","volume":"24","author":"Streeter","year":"1969","journal-title":"Circ Res"},{"key":"2023072413340565900_jead075-B22","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1161\/01.CIR.56.5.786","article-title":"The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs","volume":"56","author":"Reimer","year":"1977","journal-title":"Circulation"},{"key":"2023072413340565900_jead075-B23","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jacc.2009.03.037","article-title":"The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion","volume":"54","author":"Tan","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2023072413340565900_jead075-B24","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1161\/CIRCIMAGING.108.811620","article-title":"Cardiac mechanics in mild hypertensive heart disease: a speckle-strain imaging study","volume":"2","author":"Narayanan","year":"2009","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B25","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jcmg.2014.12.020","article-title":"Global longitudinal strain is not impaired in type 1 diabetes patients without albuminuria: the Thousand & 1 Study","volume":"8","author":"Jensen","year":"2015","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023072413340565900_jead075-B26","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1161\/CIRCEP.108.838748","article-title":"Long-term improvement in left ventricular strain after successful catheter ablation for atrial fibrillation in patients with preserved left ventricular systolic function","volume":"2","author":"Tops","year":"2009","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2023072413340565900_jead075-B27","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jacc.2013.09.052","article-title":"Impaired systolic function by strain imaging in heart failure with preserved ejection fraction","volume":"63","author":"Kraigher-Krainer","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2023072413340565900_jead075-B28","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/ejhf.659","article-title":"Left ventricular deformation at rest predicts exercise-induced elevation in pulmonary artery wedge pressure in patients with unexplained dyspnoea","volume":"19","author":"Biering-S\u00f8rensen","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2023072413340565900_jead075-B29","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1093\/ejechocard\/jep036","article-title":"Feasibility and reproducibility of left ventricular rotation parameters measured by speckle tracking echocardiography","volume":"10","author":"van Dalen","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2023072413340565900_jead075-B30","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1093\/aje\/kwk052","article-title":"Relaxing the rule of ten events per variable in logistic and Cox regression","volume":"165","author":"Vittinghoff","year":"2007","journal-title":"Am J Epidemiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/8\/999\/50945916\/jead075.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/8\/999\/50945916\/jead075.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T13:34:32Z","timestamp":1690205672000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/24\/8\/999\/7133756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4,20]]},"published-print":{"date-parts":[[2023,7,24]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jead075","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,4,20]]}}}