Association of subendocardial viability ratio and mortality in the elderly population: results from the CARdiovascular disease, Living and Ageing in Halle study

Abstract

Objectives: The subendocardial viability ratio (SEVR) reflects the balance of myocardial oxygen supply and demand. Low SEVR indicates a reduced subendocardial perfusion and has been shown to predict mortality in patients with kidney disease and diabetes. The aim of this study is to investigate the association of SEVR and mortality in the elderly population. Methods: We analysed data from the CARdiovascular disease, Living and Ageing in Halle (CARLA) study. SEVR was estimated noninvasively by radial artery tonometry and brachial blood pressure measurement. The study population was divided into a low (SEVR ≤130%) and normal (SEVR >130%) SEVR group. Cox-regression was used for survival analysis. Results: In total, 1414 participants (635 women, 779 men) aged from 50 to 87 years (mean age 67.3 years) were included in the analysis. The all-cause mortality was 22.7% during a median follow-up of 10.5 years. The unadjusted association of SEVR with all-cause mortality decreased from 3.52 (1.31–9.46) [hazard ratio (95% confidence interval) for low SEVR ≤ 130% versus normal SEVR > 130%] among those younger than 60 years to 0.86 (0.50–1.48) among those older than 80 years and from 1.81 (0.22–14.70) to 0.75 (0.30–1.91) for cardiovascular mortality. Sex-specific unadjusted analyses demonstrated an association of SEVR with all-cause and cardiovascular mortality in men [2.32 (1.61–3.34) and 2.24 (1.18–4.24)], but not in women [1.53 (0.87–2.72) and 1.14 (0.34–3.82)]. Conclusion: Our data suggests that SEVR is an age dependent predictor for all-cause mortality, predominantly in men younger than 60 years.