Abstract 12333: Do the Patients With Inertia Force of Late Systolic Aortic Flow Have Less Incidence of Heart Failure?
Inertia force of late systolic aortic flow (IF) is observed in the left ventricles (LV) with good systolic function. A lack of IF provokes isolated LV diastolic dysfunction and may be related to the pathogenesis of heart failure (HF) and reduced survival. Accordingly, we tried to identify the association of a lack of IF with future HF and all-cause mortality in patients undergoing cardiac catheterization for the assessment of coronary artery disease.
Methods: We enrolled 144 consecutive patients (age 65.8±8.9 years, male 80.5%). LV ejection fraction (LVEF) was obtained from left ventriculography. LV relaxation time constant (τ) and the IF were calculated from LV pressure (P) -dP/dt relation (phase loop). The primary endpoint of this outcome-observational study was combined subsequent HF and all-cause deaths.
Results: During the follow-up period (median 6.1years), 7 unscheduled hospitalizations for HF and 9 all-cause deaths were observed. There were no significant differences in age, sex, height, weight, mean blood pressure, or heart rate between two groups with and without prespecified events. The primary endpoint occurred in 6 of 108 patients (5.6%) in patients with IF and 10 of 36 patients (27.8%) in patients without IF. Patients with IF had significantly higher LVEF (67.4±8.5 % vs 47.4±10.0 %; p≤0.001) and significantly shorter τ (44.3±8.2 ms vs 51.0±9.8 ms; p≤0.001) than in patients without IF. Event-free survival rate was significantly higher in patients with IF than in patients without IF (log-rank, p=0.001). Results of Cox proportional hazards modeling revealed that a lack of IF was significantly associated with the primary end point (HR 7.22; 95% confidence interval [CI] 2.08-25.1; p=0.002). The AUC curve for LVEF to detect an absence of IF was 0.94 (p≤0.001). An LVEF value of 58% had a sensitivity of 87%, a specificity of 83% for detecting an absence of IF. Furthermore, LVEF ≥58% was significantly associated with primary endpoint, although LVEF value >50% had no significant relation to the endpoint.
Conclusions: A lack of the IF is the predictor of future HF and all-cause deaths. An LVEF value ≥58% could be used as a surrogate whether LVs have IF. Patients with LVEF ≥58% may have less incidence of HF and they should have good prognosis.
- © 2013 by American Heart Association, Inc.