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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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.
