Clinical and prognostic implications of left ventricular dilatation in heart failure.

Autor:	Kasa G; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Teis A; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Juncà G; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Aimo A; Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy., Lupón J; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain.; Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain., Cediel G; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain.; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain., Santiago-Vacas E; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Codina P; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Ferrer-Sistach E; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Vallejo-Camazón N; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., López-Ayerbe J; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain., Bayés-Genis A; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain.; Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain., Delgado V; Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain.; Centre for Comparative Medicine and Bioimage (CMCiB), Germans Trias i Pujol Research Institute (IGTP), Camí del Tanatori, Badalona 08916, Spain.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2024 May 31; Vol. 25 (6), pp. 849-856.
DOI:	10.1093/ehjci/jeae025
Abstrakt:	Aims: To assess the agreement between left ventricular end-diastolic diameter index (LVEDDi) and volume index (LVEDVi) to define LV dilatation and to investigate the respective prognostic implications in patients with heart failure (HF). Methods and Results: Patients with HF symptoms and LV ejection fraction (LVEF) < 50% undergoing cardiac magnetic resonance were evaluated retrospectively. LV dilatation was defined as LVEDDi or LVEDVi above the upper normal limit according to published reference values. Patients were followed up for the combined endpoint of cardiovascular death or HF hospitalization during 5 years. A total of 564 patients (median age 64 years; 79% men) were included. LVEDDi had a modest correlation with LVEDVi (r = 0.682, P < 0.001). LV dilatation was noted in 84% of patients using LVEDVi-based definition and in 73% using LVEDDi-based definition, whereas 20% of patients displayed discordant definitions of LV dilatation. During a median follow-up of 2.8 years, patients with both dilated LVEDDi and LVEDVi had the highest cumulative event rate (HR 3.00, 95% CI 1.15-7.81, P = 0.024). Both LVEDDi and LVEDVi were independently associated with the primary outcome (hazard ratio 3.29, 95%, P < 0.001 and 2.8, P = 0.009; respectively). Conclusion: The majority of patients with HF and LVEF < 50% present both increased LVEDDi and LVEDVi whereas 20% show discordant linear and volumetric definitions of LV dilatation. Patients with increased LVEDDi and LVEDVi have the worst clinical outcomes suggesting that the assessment of these two metrics is needed for better risk stratification. Competing Interests: Conflict of interest: V.D. received speaker fees from Edwards Lifesciences, GE Healthcare, Medtronic, Philips, and Novartis and consulting fees from Edwards Lifesciences, MSD and Novo Nordisk. A.B.-G. has participated in advisory and/or lectured for Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Roche Diagnostics, and Vifor. The remaining authors have nothing to disclose. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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