Left ventricular output indices in hospitalized heart failure: when 'simpler' may not mean 'better'
| Autor: | Andrea Fiorencis, Giovanni Andrea Luisi, Donato Mele, Gabriele Pestelli, Vittorio Smarrazzo, Filippo Trevisan, Davide Dal Molin, Roberto Ferrari |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Left ventricular ejection fraction medicine.medical_specialty Time Factors 030204 cardiovascular system & hematology Doppler echocardiography Risk Assessment Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Risk of mortality medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Echocardiography Heart failure Stroke volume Systolic function Stroke Aged Retrospective Studies Aged 80 and over Heart Failure Ejection fraction medicine.diagnostic_test business.industry Stroke Volume medicine.disease Prognosis Echocardiography Doppler Color Hospitalization Blood pressure Cardiology Female Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | The international journal of cardiovascular imaging. 37(1) |
| ISSN: | 1875-8312 |
| Popis: | Assessment of left ventricular (LV) output in hospitalized patients with heart failure (HF) is important to determine prognosis. Although echocardiographic LV ejection fraction (EF) is generally used to this purpose, its prognostic value is limited. In this investigation LV-EF was compared with other echocardiographic per-beat measures of LV output, including non-indexed stroke volume (SV), SV index (SVI), stroke distance (SD), ejection time (ET), and flow rate (FR), to determine the best predictor of all-cause mortality in patients hospitalized with HF. A final cohort of 350 consecutive patients hospitalized with HF who underwent echocardiography during hospitalization was studied. At a median follow-up of 2.7 years, 163 patients died. Non-survivors at follow-up had lower SD, SVI and SV, but not ET, FR and LV-EF than survivors. At multivariate analysis, only age, systolic blood pressure, chronic kidney disease, chronic obstructive pulmonary disease, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and SVI remained significantly associated with outcome [HR for SVI 1.13 (1.04–1.22), P = 0.003]. In particular, for each 5 ml/m2 decrease in SVI, a 13% increase in risk of mortality for any cause was observed. SVI is a powerful prognosticator in HF patients, better than other per-beat measures, which may be simpler but partial or incomplete descriptors of LV output. SVI, therefore, should be considered for the routine echocardiographic evaluation of patients hospitalized with HF to predict prognosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink