Abstract 14193: Strain Rather Than Ejection Fraction is a Predictor of 30-day Readmission in Patients With Heart Failure
Background: Readmissions after heart failure (HF) are a common and serious problem. Recently, LV strain has been shown to improve prognostic assessment over traditional clinical parameters. We hypothesized that these parameters could be also useful for predicting short-term readmission in pts with HF. We therefore sought to examine the echo predictors of 30-day HF readmission.
Methods: Of 291 pts (77±14 years) undergoing echocardiography around the time of a 1st admission for HF from July 2009 to June 2012, 77 were excluded due to inadequate images. We measured standard echo parameters and the three strain parameters (global longitudinal strain (GLS), global circumferential strain (GCS) and right ventricular free wall global longitudinal strain (RVGLS)) using speckle tracking (Research Arena, Tomtec, Germany). In 112 pts with atrial fibrillation, strain parameters were measured if the ratio of preceding and pre-preceding intervals was 1. Pts were followed for 30-day hospital readmission, and the association of echo features with outcome was assessed using logistic regression.
Results: The 41 of 214 pts (19%) who were readmitted had significantly lower deformation (GLS), ejection fraction and e’, and higher LVEDV and LA volume and >moderate mitral regurgitation (Table). There were no significant differences in GCS and RVGLS. In a multivariate logistic regression, GLS and >moderate mitral regurgitation were independent predictors of readmission. In sequential models, prediction of readmission a model based on LA volume, e’ and mitral regurgitation was not improved by LVEDV or ejection fraction (p=0.20), but was significantly improved by GLS (p=0.004).
Conclusion: GLS provides incremental value to standard echo for the prediction of readmission in pts with HF.
- © 2013 by American Heart Association, Inc.