| Usefulness of a combination of systolic function by left ventricular ejection fraction and diastolic function by E/E' to predict prognosis in patients with heart failure. | |
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MedLine Citation:
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PMID: 19406271 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left ventricular (LV) ejection fraction (EF) was known as a conventional predictor of heart failure (HF). However, early transmitral flow velocity (E)/early diastolic velocity of mitral annulus (E') correlated well with LV end-diastolic pressure, and E/E' ratio >15 was an excellent predictor of adverse outcomes in patients with HF. This study was designed to determine the prognostic value of a new combined index, E/E' ratio and LVEF, in patients with HF. One hundred twenty-six consecutive patients hospitalized with HF underwent comprehensive echocardiographic-Doppler study when ready for discharge. Patients were divided into the 4 groups of group I (LVEF >40% and E/E' ratio <15), group II (EF >40% and E/E' ratio >or=15), group III (EF <or=40% and E/E' ratio <15), and group IV (EF <or=40% and E/E' ratio >or=15). The ability of this index to determine the primary end point (rehospitalization for HF or cardiac death) was assessed. Patients with significant valvular disease were excluded. Of 126 patients, 110 met the inclusion criteria. Follow-up was complete for 108 of 110 patients at 351 +/- 252 days after discharge. There were 27, 30, 21, and 30 patients in groups I, II, III, and IV, respectively. There were 52 patients with the primary end point. On univariate analysis, E/E' ratio, group IV, E', and age were significant predictors. In multivariable analysis, the most powerful independent prognostic indicator of events was group IV (hazard ratio 12.6, 95% confidence interval 2.2 to 74.2, p = 0.005). In conclusion, a new index, a combination of LVEF and E/E' ratio, allowed the identification of patients at higher risk of readmission and cardiac death in patients with HF. |
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Authors:
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Kumiko Hirata; Eiichi Hyodo; Takeshi Hozumi; Ryoichi Kita; Makoto Hirose; Yuji Sakanoue; Yukio Nishida; Takahiko Kawarabayashi; Minoru Yoshiyama; Junichi Yoshikawa; Takashi Akasaka |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2009-03-09 |
Journal Detail:
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Title: The American journal of cardiology Volume: 103 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-01 Completed Date: 2009-06-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1275-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Wakayama Medical University, Wakayama, Japan. hiratakumiko@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Analysis of Variance Cause of Death* Cohort Studies Confidence Intervals Diastole / physiology Disease Progression Echocardiography, Doppler, Color Female Geriatric Assessment Heart Failure / mortality*, physiopathology*, ultrasonography Heart Function Tests Humans Kaplan-Meiers Estimate Male Predictive Value of Tests Probability Prognosis Sensitivity and Specificity Severity of Illness Index Stroke Volume / physiology* Survival Analysis Systole / physiology Ventricular Dysfunction, Left / diagnosis, mortality* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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