Usefulness of a Combination of Systolic Function by Left Ventricular Ejection Fraction and Diastolic Function by E/E′ to Predict Prognosis in Patients With Heart Failure
| Autor: | Minoru Yoshiyama, Eiichi Hyodo, Yukio Nishida, Ryoichi Kita, Kumiko Hirata, Junichi Yoshikawa, Makoto Hirose, Takeshi Hozumi, Takahiko Kawarabayashi, Yuji Sakanoue, Takashi Akasaka |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Systole Diastole Hemodynamics Kaplan-Meier Estimate Sensitivity and Specificity Severity of Illness Index Cohort Studies Ventricular Dysfunction Left Predictive Value of Tests Cause of Death Internal medicine Confidence Intervals medicine Humans cardiovascular diseases Geriatric Assessment Aged Probability Aged 80 and over Heart Failure Analysis of Variance Ejection fraction business.industry Stroke Volume Prognosis medicine.disease Survival Analysis Confidence interval Echocardiography Doppler Color Predictive value of tests Heart failure Heart Function Tests Circulatory system Disease Progression cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 103:1275-1279 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2009.01.024 |
| Popis: | Left ventricular (LV) ejection fraction (EF) was known as a conventional predictor of heart failure (HF). However, early transmitral flow velocity (E)/early diastolic velocity of mitral annulus (E') correlated well with LV end-diastolic pressure, and E/E' ratio15 was an excellent predictor of adverse outcomes in patients with HF. This study was designed to determine the prognostic value of a new combined index, E/E' ratio and LVEF, in patients with HF. One hundred twenty-six consecutive patients hospitalized with HF underwent comprehensive echocardiographic-Doppler study when ready for discharge. Patients were divided into the 4 groups of group I (LVEF40% and E/E' ratio15), group II (EF40% and E/E' ratioor=15), group III (EFor=40% and E/E' ratio15), and group IV (EFor=40% and E/E' ratioor=15). The ability of this index to determine the primary end point (rehospitalization for HF or cardiac death) was assessed. Patients with significant valvular disease were excluded. Of 126 patients, 110 met the inclusion criteria. Follow-up was complete for 108 of 110 patients at 351 +/- 252 days after discharge. There were 27, 30, 21, and 30 patients in groups I, II, III, and IV, respectively. There were 52 patients with the primary end point. On univariate analysis, E/E' ratio, group IV, E', and age were significant predictors. In multivariable analysis, the most powerful independent prognostic indicator of events was group IV (hazard ratio 12.6, 95% confidence interval 2.2 to 74.2, p = 0.005). In conclusion, a new index, a combination of LVEF and E/E' ratio, allowed the identification of patients at higher risk of readmission and cardiac death in patients with HF. |
| Databáze: | OpenAIRE |
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