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Independent and incremental prognostic value of Doppler-derived left ventricular total isovolumic time in patients with systolic heart failure.
MedLine Citation:
PMID:  19948365     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: A prolonged total isovolumic time (T-IVT) has been shown to be associated with worsening survival in patients submitted to coronary artery surgery. However, it is not known whether it has prognostic significance in patients with chronic systolic heart failure (HF).
AIM: To determine the prognostic value of T-IVT in comparison with other clinical, biochemical and echocardiographic variables in patients with chronic systolic HF.
METHODS: Patients (n=107; age 68±12years, 25% women) with chronic systolic HF, left ventricular ejection fraction (EF) <45%, and sinus rhythm, underwent a complete Doppler echocardiographic study, that included tissue Doppler long axis velocities and total isovolumic time (T-IVT), determined as [60-(total ejection time+total filling time)]. Plasma N-terminal pro-B natriuretic peptide (NT-pro-BNP) was also measured. The associations of dichotomous variables selected according to the Receiver Operator Characteristic analysis were assessed using the Cox proportional hazard model.
RESULTS: Follow-up period was 37±18months. Multivariate predictors of events were T-IVT ≥12.3% s/min, mean E/E(m) ratio ≥10, log NT-pro-BNP levels ≥2.47pg/ml and LV EF≤32.5%. On Kaplan-Meier analysis, patients with prolonged T-IVT, high mean E/E(m) ratio, increased NT-pro-BNP levels and decreased LV EF had a worse outcome compared with those without. The addition of T-IVT and NT-pro-BNP to conventional clinical and echocardiographic variables significantly improved the chi-square for the prediction of the outcome from 33.1 to 38.0, (P<0.001).
CONCLUSIONS: Prolonged T-IVT added to the prognostic stratification of patients with systolic HF.
Authors:
Gani Bajraktari; Frank Lloyd Dini; Paolo Fontanive; Shpend Elezi; Venera Berisha; Anna Maria Napoli; Manrico Ciuti; Michael Henein
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Publication Detail:
Type:  Journal Article     Date:  2009-11-30
Journal Detail:
Title:  International journal of cardiology     Volume:  148     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  271-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo.
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