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 <or=140 ms and non-RF when >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.
RCT Entities:
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 <or=140 ms and non-RF when >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.
Authors: Charlotte Andersson; Gunnar H Gislason; Peter Weeke; Jesper Kjaergaard; Christian Hassager; Dilek Akkan; Jacob E Møller; Lars Køber; Christian Torp-Pedersen Journal: BMC Cardiovasc Disord Date: 2012-04-25 Impact factor: 2.298
Authors: Dorinna D Mendoza; Noel C F Codella; Yi Wang; Martin R Prince; Sonia Sethi; Shant J Manoushagian; Keigo Kawaji; James K Min; Troy M LaBounty; Richard B Devereux; Jonathan W Weinsaft Journal: J Cardiovasc Magn Reson Date: 2010-07-31 Impact factor: 5.364
Authors: Morten Schou; Jesper Kjaergaard; Christian Torp-Pedersen; Christian Hassager; Finn Gustafsson; Dilek Akkan; Jacob E Moller; Lars Kober Journal: BMC Nephrol Date: 2013-12-03 Impact factor: 2.388