{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:39:29Z","timestamp":1789961969777,"version":"4.0.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Pressure-strain loop analyses is a noninvasive technique capable of evaluating myocardial work. Reference values are needed to benchmark these myocardial work indices for clinical practice.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Healthy participants from a general population study were used to establish reference values for global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) measured by pressure-strain loop analyses. The relation to age and sex was examined. We furthermore examined the proportion of abnormal work indices according to low, intermediate, and high cardiovascular risk by the Framingham risk score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The healthy sample consisted of 1827 participants (median age, 45 years; 39% men). Lower reference values were GWI, 1576 mm\u2009Hg%; GCW, 1708 mm\u2009Hg%; and GWE, 93.0% and upper reference value for GWW was 159 mm\u2009Hg%. Women exhibited significantly higher GWI, GCW, and GWW and lower GWE. Sex significantly modified the association between all indices and age (\n              <jats:italic>P<\/jats:italic>\n              for interaction: 0.001 for GWI, 0.009 for GCW, 0.003 for GWW, and 0.009 for GWE). For men, only GCW increased with age, whereas the other indices did not change with age. For women, GCW increased linearly with increasing age, whereas GWI, GWW, and GWE changed in a curvilinear fashion with age such that GWI increased in younger participants, GWW increased in elderly, and GWE declined concordantly. Abnormalities in myocardial work indices became more frequent with increasing Framingham risk score category (abnormal GWI: 2% versus 4% versus 5%,\n              <jats:italic>P<\/jats:italic>\n              =0.001; abnormal GCW: 2% versus 3% versus 4%,\n              <jats:italic>P<\/jats:italic>\n              =0.006; abnormal GWW: 3% versus 6% versus 11%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; abnormal GWE: 3% versus 4% versus 11%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Myocardial work indices differ between sexes and change with age in a sex-dependent manner. Accordingly, we established age- and sex-specific reference values from a general population sample. Abnormal work indices become more frequent with higher clinical risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02993172.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.121.013712","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T09:00:14Z","timestamp":1652173214000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":61,"title":["Normal Values for Myocardial Work Indices Derived From Pressure-Strain Loop Analyses: From the CCHS"],"prefix":"10.1161","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct02993172","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9511-8375","authenticated-orcid":true,"given":"Flemming Javier","family":"Olsen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."},{"name":"Department of Biomedical Sciences (F.J.O., N.D.J., M.S., T.B.-S.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2690-7511","authenticated-orcid":true,"given":"Kristoffer Grundtvig","family":"Skaarup","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2255-582X","authenticated-orcid":true,"given":"Mats Christian H\u00f8jbjerg","family":"Lassen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6959-3236","authenticated-orcid":true,"given":"Niklas Dyrby","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."},{"name":"Department of Biomedical Sciences (F.J.O., N.D.J., M.S., T.B.-S.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Sengel\u00f8v","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."},{"name":"Department of Biomedical Sciences (F.J.O., N.D.J., M.S., T.B.-S.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorm Boje","family":"Jensen","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schnohr","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9170-4190","authenticated-orcid":true,"given":"Jacob Louis","family":"Marott","sequence":"additional","affiliation":[{"name":"The Copenhagen City Heart Study, Copenhagen University Hospital\u2013Frederiksberg and Bispebjerg Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"S\u00f8gaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (P.S., G.G., J.H.S., R.M.), University of Copenhagen, Denmark."},{"name":"Department of Cardiology, Copenhagen University Hospital\u2013North Zealand Hospital, Hilleroed, Denmark (P.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-402X","authenticated-orcid":true,"given":"Gunnar","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Herlev and Gentofte, Hellerup, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.G., T.B.-S.)."},{"name":"Department of Clinical Medicine (P.S., G.G., J.H.S., R.M.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-8515","authenticated-orcid":true,"given":"Jesper Hastrup","family":"Svendsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (P.S., G.G., J.H.S., R.M.), University of Copenhagen, Denmark."},{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Rigshospitalet, Denmark (J.H.S., R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"M\u00f8gelvang","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (P.S., G.G., J.H.S., R.M.), University of Copenhagen, Denmark."},{"name":"Department of Cardiology, Copenhagen University Hospital\u2013Rigshospitalet, Denmark (J.H.S., R.M.)."},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense (R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Moene","family":"Aalen","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research and Department of Cardiology, Rikshospitalet, Oslo University Hospital and University of Oslo, Norway (J.M.A., E.W.R., O.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Espen Wattenberg","family":"Remme","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research and Department of Cardiology, 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Hospital, Denmark (F.J.O., K.G.S., M.C.H.L., N.D.J., M.S., G.B.J., P.S., J.L.M., T.B.-S.)."},{"name":"Department of Biomedical Sciences (F.J.O., N.D.J., M.S., T.B.-S.), University of Copenhagen, 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The effect of gender on age-related blood pressure changes and the prevalence of isolated systolic hypertension among older adults: data from NHANES III. 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