Document Detail


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.
MedLine Citation:
PMID:  19406271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kumiko Hirata; Eiichi Hyodo; Takeshi Hozumi; Ryoichi Kita; Makoto Hirose; Yuji Sakanoue; Yukio Nishida; Takahiko Kawarabayashi; Minoru Yoshiyama; Junichi Yoshikawa; Takashi Akasaka
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-03-09
Journal Detail:
Title:  The American journal of cardiology     Volume:  103     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1275-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Wakayama Medical University, Wakayama, Japan. hiratakumiko@aol.com
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MeSH Terms
Descriptor/Qualifier:
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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