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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
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.