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Prognostic importance of a short deceleration time in symptomatic congestive heart failure.

Abstract：

AIMS:A restrictive transmitral filling (RF) pattern predicts increased mortality in heart failure (HF) with reduced left ventricular (LV) systolic function. We performed a combined evaluation of LV function and RF for prognosis in patients with HF with and without systolic dysfunction. METHODS AND RESULTS:Doppler echocardiography was performed in 972 patients with symptomatic HF. RF was considered present when deceleration time (DT) was 140 ms. A DT >240 ms was defined as delayed relaxation. During a median of 51 months the unadjusted all-cause mortality rates were significantly increased among patients with RF vs. the non-RF group (1- and 4-year mortality was 25% and 54% vs. 17% and 43%). In a multivariable model, RF was a significant predictor of all-cause mortality (hazard ratio (HR)=2.0, 95% confidence interval (CI):1.5-2.6) whereas delayed relaxation was without prognostic importance (HR=0.9, CI:0.5-1.6). Repeating the multivariable model in subgroups of wall motion index (WMI) showed that RF was a strong predictor of mortality independent of WMI. For patients with LVEF of at least 50%, HR for RF was 2.0 (CI:1.1-3.4; p=0.02) and interaction between LVEF and RF was not significant. CONCLUSION:In a heterogeneous population hospitalised for symptomatic HF a restrictive transmitral filling pattern, defined as shortened deceleration time, during hospitalisation is an ominous prognostic sign independent of LV systolic function.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Akkan D,Kjaergaard J,Møller JE,Hassager C,Torp-Pedersen C,Køber L,EchoCardiography and Heart Outcome Study (ECHOS) investigators.

doi

10.1016/j.ejheart.2008.05.007

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

689-95

issue

7

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(08)00235-3

journal_volume

10

pub_type

杂志文章,多中心研究,随机对照试验

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