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Prognostic value of septal E/(E'×S') ratio in predicting cardiac death in patients with heart failure.

Abstract：

BACKGROUND:A new tissue Doppler index, E/(E'×S'), including the early diastolic transmitral/mitral annular velocity (E/E') ratio and systolic mitral annular velocity (S'), has a good accuracy in predicting left ventricular filling pressure. AIM:To investigate the value of E/(E'×S') measured at different sites of the mitral annulus to predict cardiac death in patientswith heart failure (HF). METHODS:Echocardiography was performed in 342 consecutive hospitalised patients with HF, in sinus rhythm, at hospital discharge and after one month. Velocities were determined at septal and lateral mitral annular sites, and average values obtained. E/(E'×S') worsening was defined as a value greater than the value determined at discharge. The end point was cardiac death. RESULTS:During the follow-up period (35 ± 8.8 months), cardiac death occurred in 52 (15.2%) patients. Septal E/(E'×S') at hospital discharge presented the largest area under receiver operating characteristic (ROC) curve to predict cardiac death (0.85,95% CI 0.79-0.90, p < 0.001). A statistical comparison of the ROC curves demonstrated no significant differences between septal and average E/(E'×S') (p = 0.54), but the accuracy of septal E/(E'×S') was better compared to the other analysed echocardiographic parameters [E/(E'×S'), E/E', S', etc., all p < 0.05]. The optimal septal E/(E'×S') cut-off was 3.03 (75% sensitivity,83% specificity). Before discharge, 96 (28.1%) patients presented septal E/(E'×S') > 3.03. Cardiac death was significantly higher in patients with E/(E'×S') > 3.03 (39 deaths, 40.2% vs. 13 deaths, 5.3%, p < 0.001). Patients with septal E/(E'×S') > 3.03 at discharge and worsening after one month presented the worst prognosis in the overall population. CONCLUSIONS:Septal E/(E'×S') is a powerful predictor of cardiac death in patients with HF.

journal_name

Kardiol Pol

journal_title

Kardiologia polska

authors

Mornos C,Petrescu L,Pescariu S,Dan R,Cozma D

doi

10.5603/KP.a2013.0281

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

166-74

issue

eissn

0022-9032

issn

1897-4279

pii

VM/OJS/KP/7775

journal_volume

pub_type

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Prognostic value of septal E/(E'×S') ratio in predicting cardiac death in patients with heart failure.