Comparison of usefulness of echocardiographic Doppler variables to left ventricular end-diastolic pressure in predicting future heart failure events

Hsin Yueh Liang, Sanderson A. Cauduro, Patricia A. Pellikka, Kent R. Bailey, Brandon R. Grossardt, Eric H. Yang, Chiranjit Rihal, James B. Seward, Fletcher A. Miller, Theodore P. Abraham

Research output: Contribution to journalArticle

Abstract

We sought to determine whether the echocardiographic Doppler parameters of left ventricular diastolic dysfunction predict future heart failure (HF) events and, if so, which parameters best predict HF. We also examined whether the predictive ability of echocardiographic Doppler parameters was related to their prediction of left ventricular end-diastolic pressure (LVEDP). We studied patients who underwent cardiac catheterization and echocardiography performed within a 30-day period. The end point was HF, defined as new-onset or recurrent HF diagnosed by a physician and requiring the initiation or modification of treatment of HF. We identified 289 patients (mean age 63.5 ± 12.6 years) with a mean follow-up of 10.9 ± 10.2 months. A total of 24 HF events occurred. LVEDP was a significant predictor of HF univariately and independently in multiple regression models after adjustment for ejection fraction. In Cox models adjusted for age, gender, LVEDP, and ejection fraction, only the left atrial volume index and early mitral inflow to early diastolic tissue velocity (E/e′) ratio remained predictive of HF. A multiple regression model, including all echocardiographic variables, showed a persistent, although attenuated, relation of early to late mitral inflow velocity (E/A) ratio and E/e′ with LVEDP (p = 0.06 and p = 0.002, respectively). The addition of E/e′ or the left atrial volume indexed to body surface area, but not E/A, to the clinical history and left ventricular ejection fraction provided incremental prognostic information. A LVEDP of 2 identified those with a higher risk of HF. In conclusion, invasively determined LVEDP is an independent predictor of future HF events. E/e′ and the left atrial volume indexed to body surface area are the best independent predictors of future HF and provide prognostic information incremental to the clinical history and left ventricular ejection fraction.

Original languageEnglish (US)
Pages (from-to)866-871
Number of pages6
JournalThe American Journal of Cardiology
Volume97
Issue number6
DOIs
StatePublished - Mar 15 2006
Externally publishedYes

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Heart Failure
Blood Pressure
Body Surface Area
Stroke Volume
Left Ventricular Dysfunction
Cardiac Catheterization
Treatment Failure
Proportional Hazards Models
Echocardiography
Physicians

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of usefulness of echocardiographic Doppler variables to left ventricular end-diastolic pressure in predicting future heart failure events. / Liang, Hsin Yueh; Cauduro, Sanderson A.; Pellikka, Patricia A.; Bailey, Kent R.; Grossardt, Brandon R.; Yang, Eric H.; Rihal, Chiranjit; Seward, James B.; Miller, Fletcher A.; Abraham, Theodore P.

In: The American Journal of Cardiology, Vol. 97, No. 6, 15.03.2006, p. 866-871.

Research output: Contribution to journalArticle

Liang, HY, Cauduro, SA, Pellikka, PA, Bailey, KR, Grossardt, BR, Yang, EH, Rihal, C, Seward, JB, Miller, FA & Abraham, TP 2006, 'Comparison of usefulness of echocardiographic Doppler variables to left ventricular end-diastolic pressure in predicting future heart failure events', The American Journal of Cardiology, vol. 97, no. 6, pp. 866-871. https://doi.org/10.1016/j.amjcard.2005.09.136
Liang, Hsin Yueh ; Cauduro, Sanderson A. ; Pellikka, Patricia A. ; Bailey, Kent R. ; Grossardt, Brandon R. ; Yang, Eric H. ; Rihal, Chiranjit ; Seward, James B. ; Miller, Fletcher A. ; Abraham, Theodore P. / Comparison of usefulness of echocardiographic Doppler variables to left ventricular end-diastolic pressure in predicting future heart failure events. In: The American Journal of Cardiology. 2006 ; Vol. 97, No. 6. pp. 866-871.
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AU - Liang, Hsin Yueh

AU - Cauduro, Sanderson A.

AU - Pellikka, Patricia A.

AU - Bailey, Kent R.

AU - Grossardt, Brandon R.

AU - Yang, Eric H.

AU - Rihal, Chiranjit

AU - Seward, James B.

AU - Miller, Fletcher A.

AU - Abraham, Theodore P.

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N2 - We sought to determine whether the echocardiographic Doppler parameters of left ventricular diastolic dysfunction predict future heart failure (HF) events and, if so, which parameters best predict HF. We also examined whether the predictive ability of echocardiographic Doppler parameters was related to their prediction of left ventricular end-diastolic pressure (LVEDP). We studied patients who underwent cardiac catheterization and echocardiography performed within a 30-day period. The end point was HF, defined as new-onset or recurrent HF diagnosed by a physician and requiring the initiation or modification of treatment of HF. We identified 289 patients (mean age 63.5 ± 12.6 years) with a mean follow-up of 10.9 ± 10.2 months. A total of 24 HF events occurred. LVEDP was a significant predictor of HF univariately and independently in multiple regression models after adjustment for ejection fraction. In Cox models adjusted for age, gender, LVEDP, and ejection fraction, only the left atrial volume index and early mitral inflow to early diastolic tissue velocity (E/e′) ratio remained predictive of HF. A multiple regression model, including all echocardiographic variables, showed a persistent, although attenuated, relation of early to late mitral inflow velocity (E/A) ratio and E/e′ with LVEDP (p = 0.06 and p = 0.002, respectively). The addition of E/e′ or the left atrial volume indexed to body surface area, but not E/A, to the clinical history and left ventricular ejection fraction provided incremental prognostic information. A LVEDP of 2 identified those with a higher risk of HF. In conclusion, invasively determined LVEDP is an independent predictor of future HF events. E/e′ and the left atrial volume indexed to body surface area are the best independent predictors of future HF and provide prognostic information incremental to the clinical history and left ventricular ejection fraction.

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