Abstract 12234: Risk Stratification of Heart Failure Patients With Preserved Ejection Fraction by Multiple Echocardiographic Parameters.
Recently, the prevalence of heart failure with preserved ejection fraction (HFpEF) has increased. However, a promising echocardiographic parameter predicting prognosis of HFpEF remains to be determined. Therefore, we examined whether combined evaluation of multiple parameters of diastolic dysfunction obtained by transthoracic echocardiography can predict cardiac events such as cardiac death or rehospitalization for heart failure.We performed transthoracic echocardiography at discharge in 93 patients with HFpEF (EF ≥50%) hospitalized for congestive heart failure (75 ± 10 years old) and prospectively follow up. We defined that diastolic dysfunction score (DDS) was formed by assigning 1 point each for the presence of the abnormal value for deceleration time (DT, positive if<140), the ratio of E-wave to the peak early mitral annular velocities (E/e', positive if>10), and left atrial volume index (LAVI, positive if>42). We defined patients with DDS≥2 had a severe diastolic dysfunction. There were 31 cardiac events (33%) during median follow up period of 400 days (range 17–990 days). There were no significant differences in prevalence of atrial fibrillation, left ventricular end-diastolic dimension and ejection fraction between patients with and without cardiac events. However, patients with DDS≥2 had markedly higher cardiac events than in those with DDS<1 (68 vs. 29%, P<0.01). Plasma BNP level at discharge increased with advancing DDS. The multivariate Cox proportional hazard analysis revealed that high DDS was an independent predictor for cardiac events (hazard ratio, 2.849; 95% confidence interval, 1.200–6.756; P=0.02). Kaplan-Meier survival analysis showed that DDS could reliability risk stratify patients with HFpEF for cardiac event. In Conclusions, combined evaluation of echocardiographic parameters may be a feasible schema predicting prognosis of patients with HFpEF.
- © 2010 by American Heart Association, Inc.