Abstract 11462: Do Changes in Echocardiographic Parameters Predict Survival in Patients with Heart Failure?
Introduction: Heart failure (HF) clinics were established to optimize HF treatment. Several echocardiographic parameters have been shown to predict adverse outcomes. It is unknown, however, whether improvement in these parameters after registration into HF clinic is predictive. We studied echocardiographic parameters in HF clinic patients to determine if their improvement predicted survival over 5 years of follow-up.
Methods: We reviewed the HF and echo databases in a tertiary care center for patients registered between January 2002 and June 2008. Patients had an echocardiogram ≤ 1 year prior to registration and another ≥ 1 month after treatment onset. Echocardiographic data included LV ejection fraction, LV end-diastolic and systolic dimensions, mitral E/A ratio, deceleration time (DT), tissue Doppler E’ velocity, MR and TR, systolic pulmonary artery pressure (sPAP), and RV function. Survival curves and hazard ratios were generated for parameter improvement versus non-improvement. Multivariable analyses were performed adjusting for age, gender, ischemic etiology and atrial fibrillation.
Results: We analyzed 404 patients. The average follow-up was 2.9 ± 1.5 years with mean time between echocardiograms 11 ± 7 months. Treatment duration was 9 ± 7 months. Improvement in LV ejection fraction, LV end diastolic and systolic dimensions, MR and TR, DT, sPAP and RV function predicted survival. Mitral E/A was marginally statistically associated with survival in patients with sinus rhythm. Improvement in LV end-systolic dimension (p <0.05), RV function (p <0.0001) and MR (p <0.003) were independent predictors of survival in multivariable analysis.
Conclusions: Improvement in several echocardiographic parameters post-admission to HF clinic predicted survival over 5 years. Of these, improvement in LV end-systolic dimension, RV function and MR were independent predictors of survival after adjusting for age, gender, ischemic etiology and atrial fibrillation.
- © 2011 by American Heart Association, Inc.