Literature DB >> 20930426

Electromechanical activation time in the prediction of discharge outcomes in patients hospitalized with acute heart failure syndrome.

Tze-Fan Chao1, Shih-Hsien Sung, Hao-Min Cheng, Wen-Chung Yu, Kang-Ling Wang, Chi-Ming Huang, Chen-Huan Chen.   

Abstract

OBJECTIVE: Left ventricular systolic time intervals, including pre-ejection period (PEP), ejection time (ET), and their ratio (PEP/ET), is determined by systolic and diastolic function and ventriculo-arterial coupling. We investigated the usefulness of the electromechanical activation time [(EMAT) PEP minus isovolumic contraction time] in the prediction of cardiac mortality or re-hospitalization for heart failure in patients with the acute heart failure syndrome (AHFS). PATIENTS AND METHODS: A total of 45 patients (71.9±16.1 years old) hospitalized for AHFS were enrolled. Systolic time intervals and EMAT normalized by cardiac cycle length (%) were measured separately by separate automated acoustic devices. All parameters were assessed within 24 hours of admission, before discharge, and 2 weeks after discharge.
RESULTS: During a mean follow-up of 242±156 days, 20 patients (44%) incurred adverse cardiovascular events including 18 re-hospitalizations for heart failure and 2 cardiovascular deaths. Using uni-variate Cox regression analysis, at admission %EMAT and %PEP, pre-discharge %EMAT, and post-discharge %EMAT significantly predicted post-discharge cardiovascular events with hazard ratios and 95% confidence intervals of 1.75 (1.13-2.70), 1.67 (1.02-2.70), 1.87 (1.10-3.17) and 2.50 (1.58-3.97) per 1-SD increment, respectively. The predictions remained significant after adjustment for age, sex, left ventricular ejection fraction, E/E´ by Doppler echocardiography, and serum N-terminal pro-brain natriuretic peptide.
CONCLUSION: EMAT measured during the hospitalization course is useful in the prediction of cardiovascular outcomes in patients with AHFS independent of left ventricular ejection fraction, E/E´, and serum N-terminal pro-brain natriuretic peptide.

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Year:  2010        PMID: 20930426     DOI: 10.2169/internalmedicine.49.3944

Source DB:  PubMed          Journal:  Intern Med        ISSN: 0918-2918            Impact factor:   1.271


  10 in total

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7.  Night-time electromechanical activation time, pulsatile hemodynamics, and discharge outcomes in patients with acute heart failure.

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10.  Predictive Value of Electromechanical Activation Time for In-Hospital Major Cardiac Adverse Events in Heart Failure Patients.

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  10 in total

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