Prognostic Value of a Tissue Doppler Index of Systodiastolic Function in Patients with Asymptomatic Heart Failure.
Introduction
Doppler echocardiography with early diastolic transmitral velocity (E)/early mitral annular diastolic velocity (E') ratio has been proposed as the best predictor for evaluating left ventricle (LV) filling pressure. A dimensionless index E/(E' × S') ratio (S' = systolic mitral annulus velocity) resulted in readily, reproducible, and reliable predictor of LV filling pressure. We assessed the prognostic impact of E/E' × S') in patients with asymptomatic heart failure (HF).


Materials and Methods
We calculated E/(E' × S') in 337 patients (179 male, 53%; age 54.7 ± 13.7 years) using the average of septal and lateral mitral annular velocities. We considered a composite endpoint as follows: all-cause death, acute myocardial infarction, stroke, and HF exacerbation.


Results
Baseline ejection fraction resulted 60.2 ± 11.8%; E/E' × S') was 1.45 ± 0.8, with S' 7.4 ± 2.4 cm/s and E/E' 9.5 ± 5.4. After a 22-month median follow-up, there were 42 events: 5 deaths (12%), 3 acute myocardial infarctions (7%), 1 stroke (2%), and 33 HF hospitalizations (79%). In patients reaching the composite endpoint, E/(E' × S') resulted 2.07 ± 1.1 versus 1.3 ± 0.7 in event-free population (P < 0.001). In a Cox-regression analysis, adjusted for confounding clinical factors and conventional echo parameters, E/(E' × S') (P < 0.001), age (P < 0.001), and male gender (P = 0.03) resulted independent predictors of the composite endpoint.


Conclusions
E/(E' × S') was an independent predictor for the future cardiac events in asymptomatic HF.
['Pugliese|Nicola Riccardo|NR|', 'Fabiani|Iacopo|I|', 'La Carrubba|Salvatore|S|', 'Carerj|Scipione|S|', 'Conte|Lorenzo|L|', 'Colonna|Paolo|P|', 'Caso|Pio|P|', 'Benedetto|Frank|F|', 'Antonini-Canterin|Francesco|F|', 'Romano|Maria Francesca|MF|', 'Citro|Rodolfo|R|', 'Di Bello|Vitantonio|V|', '|||']
heart failure Echocardiography prognosis tissue Doppler Imaging