The aim was to study the prognostic value of left ventricular (LV) function using
pulse-wave tissue Doppler imaging (TDI) in an ordinary population with heart failure
(HF). One hundred fifty-six patients hospitalized for HF and LV ejection fraction
≤40% were examined using conventional echocardiography and pulse-wave TDI for the
assessment of longitudinal LV function. Mitral annular systolic and early diastolic
(e′) velocities were recorded from a mean of 4 annular sites from the apical 2- and
4-chamber views. Noninvasive LV filling pressure was calculated from the ratio between
transmitral early inflow velocity (E) and e′. All patients were followed up for 2
years, and data from the National Registry of Deaths were collected. Mean LV ejection
fraction was 24.7 ± 7.2%. TDI recordings showed a mean mitral annular systolic velocity
of 5.0 ± 1.0 cm/s and e′ velocity of 6.2 ± 1.9 cm/s. E/e′ ratio was 14.1 ± 4.8. Thirty
patients (19%) had atrial fibrillation. During follow-up, 27 patients (17%) died of
a cardiovascular cause. Multivariate analysis showed that only E/e′ ratio and age
were predictors of cardiovascular mortality. A cut-off value for E/e′ ratio >13 had
sensitivity of 84% and specificity of 45% to identify patients who died within 2 years
of cardiac reasons. In conclusion, in the acute stage of HF, E/e′ ratio is a strong
independent predictor of long-term cardiovascular mortality in an ordinary population
with HF and systolic dysfunction. Systolic and diastolic velocities had no independent
prognostic value.
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References
- Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function.Am J Cardiol. 1996; 77: 979-984
- Comparison of early diastolic mitral annular velocity and flow propagation velocity in detection of mild to moderate left ventricular diastolic dysfunction.Eur J Echocardiogr. 2004; 5: 196-204
- Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function.J Am Coll Cardiol. 1997; 30: 474-480
- Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation.Am J Cardiol. 1997; 79: 921-928
- Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures.J Am Coll Cardiol. 1997; 30: 1527-1533
- Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study.Circulation. 2000; 102: 1788-1794
- Peak early diastolic mitral annulus velocity by tissue Doppler imaging adds independent and incremental prognostic value.J Am Coll Cardiol. 2003; 41: 820-826
- Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure.J Am Coll Cardiol. 2005; 45: 1223-1226
- Prognostic value of systolic mitral annular velocity measured with Doppler tissue imaging in patients with chronic heart failure caused by left ventricular systolic dysfunction.Heart. 2006; 92: 775-779
- Tissue Doppler derived index of left ventricular filling pressure, E/E′, predicts survival of patients with non-valvular atrial fibrillation.Heart. 2006; 92: 1248-1252
- Recommendations for quantification of the left ventricle by two-dimensional echocardiography.J Am Soc Echocardiogr. 1989; 2: 358-367
- Prognostic value of tissue Doppler imaging in patients with chronic congestive heart failure.Int J Cardiol. 2005; 103: 175-181
Article info
Publication history
Published online: August 07, 2008
Accepted:
April 23,
2008
Received in revised form:
April 23,
2008
Received:
January 23,
2008
Footnotes
This work was supported by a grant from Stockholms läns landsting (ALF medicine), Stockholm, Sweden.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
