Abstract 16491: The Ratio of Early Diastolic Peak Velocities at Tricuspid and Mitral Annulus is a Novel Prognostic Parameter in Patients with Heart Failure

Abstract

Early diastolic peak velocity at mitral (E’) and tricuspid annulus (rE’) are associated with left (LV) and right ventricular (RV) dysfunction. However, prognostic value of rE’/E’ in heart failure remains to be determined. We performed transthoracic echocardiography in 104 patients with heart failure without pulmonary disease (60 males, 73 ± 14 years). There were 54 cardiac events during a median followed-up period of 258 days. There were no significant differences in NYHA class and the prevalence of hypertension, diabetes mellitus, and dyslipidemia between patients with and without cardiac events. There were no significant differences in left ventricular ejection fraction and medications such as angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, beta-blocker, and diuretic drug between patients with and without cardiac events. Patients with cardiac events had higher left atrial volume index, larger LV end-diastolic volume, and higher E wave in LV and RV inflow compared to those without. Since rE’ was higher and E’ was lower in patients with cardiac events than in those without, we thought that rE’/E’ may be a promising prognostic parameter. In multiple regression analysis, rE’/E’ was significantly correlated with log brain natriuretic peptide levels. Multiple Cox hazard analysis revealed that rE’/E’ was an independent predictor for cardiac events. Kaplan-Meier analysis showed that cardiac event rate was significantly higher in patients with high rE’/E’ (> 1.44) compared with those with low rE’/E’ (33% vs. 74%, p<0.001). In conclusion, rE’/E’ may be a novel prognostic parameter in patients with heart failure.