Abstract 15926: Usefullness of Peak Mitral Regurgitation Velocity to Left Ventricular Outflow Tract Time Velocity Integral Ratio as a New Prognostic Marker in Failing Heart
Introduction: Systemic vascular resistance (SVR), a neglected hemodynamic parameter, provides a precious tool for risk estimation and therapy guidance in advanced heart failure (HF). Routine right heart catheterization for this purpose is an invasive technique with potential procedural risks. So, noninvasive techniques by using Doppler may be more practical for estimation of SVR. The ratio of peak mitral regurgitation velocity (MRV) to left ventricular outflow tract time-velocity integral (LVOT TVI) was showed a good correlation with SVR obtained by right heart catheterization. Herein, we aimed to assess the predictive role of MRV/LVOT TVI ratio for follow-up all-cause mortality in HF .
Methods: A total of 80 patients with HF (LVEF <30%) and age- and gender-matched 20 healthy control subjects were enrolled. All participants underwent transthoracic echocardiography.
Results: MRV/LVOT TVI ratio was higher in HF group compared to the control group (0.48±0.16 vs. 0.25±0.04, p<0.001). Among HF patients, MRV/LVOT TVI ratio was the highest in NYHA class 4 group (p<0.001), and it was positively correlated with functional status (β=0.590, p<0.001). MRV/LVOT TVI ratio was positively correlated with troponin I (β=0.357, p<0.001), serum BNP level (β=0.343, p=0.016), uric acid level (β=0.282, p=0.009) and negatively correlated with peak VO2 (β=-0.60, p<0.001), SEATTLE score derived life expectancy (β=-0.297, p=0.007). In multivariate Cox regression analysis, MRV/LVOT TVI ratio (HR=15,52 95% CI: 2.814-85.602 p=0.002) was found as the significant predictor for all cause mortality in HF patients, independent from other risk factors. In ROC analyis, a cut of value 0.46 for MRV/LVOTTVI ratio 68.8% sensitivity and 70.5% specifity for prediction of one-year mortality (AUC=0.755 p=0.001).
Conclusion: Our study revealed that MRV/LVOT TVI ratio as a reflector of SVR, was an independent predictor of all-cause mortality in HF patients. This simple, available and non-invasive parameter may guide practitioners for risk stratification and more aggressive management of HF patients.
Author Disclosures: M.S. Cetin: None. E.H. Ozcan Cetin: None. U. Canpolat: None. S. Aydin: None. Y. Akin Guray: None. D. Aras: None. A. Temizhan: None. S. Aydogdu: None.
- © 2014 by American Heart Association, Inc.