Abstract 18367: Echocardiographic Assessment of Myocardial Wall Stress to Risk Stratify Patients With Heart Failure
Introduction: Heart failure (HF) is the most common cause of rehospitalization in the US and is associated with high morbidity and mortality. These high rates were partly due to the lack of reliable predictors.
Hypothesis: Left ventricular (LV) wall stress is one of the major factors that determine myocardial oxygen consumption and contribute to ventricular remodeling. It is directly proportional to LV wall tension and inversely proportion to LV wall thickness. The role of LV wall stress from echocardiogram and HF readmission has never been studied.
Methods: We prospectively enrolled the study participants of age 18 or older who were admitted to Buffalo General Medical Center and whom echocardiography were ordered. Exclusion criteria were patients with severe valvular diseases and poor quality study. LV wall stress measurement was calculated according to Laplace’s equation from mid-cavity parasternal short axis view of transthoracic echocardiogram. The primary endpoints include 30 day readmission, 30 day and 1 year mortality which were abstracted from the electronic medical record and confirmed with follow up calls. Since there have been no established cut-points for LV wall stress, it was categorized to be high or low comparing to the mean from study participants.
Results: The median of LV systolic and diastolic wall stress were 62.84 and 10.10 mmHg. There were 109 study participants enrolled in the study and currently 19 patients completed 1 year follow up. Between high and low systolic LV wall stress, there were no significant differences in 30 day readmission (20.41% vs 27.77% p-value 0.44) , 30 day mortality (2.00% vs 4.35% p-value 0.51) and 1 year mortality (30.00% vs 44.44% p-value 0.51). Between high and low diastolic LV wall stress, there were no significant differences in 30 day readmission (28.26% vs 16.67% p-value 0.19), 30 day mortality (4.17 % vs 2.33% p-value 0.62) and 1 year mortality (28.57% vs 33.33% p-value 0.85).
Conclusions: High LV systolic and diastolic wall stress were not associated with 30 day readmission, 30 day and 1 year mortality; however higher 30 day readmission and mortality were observed in patients with high diastolic LV wall stress. Further study is needed to further advance our understanding of LV wall stress and readmission risk.
Author Disclosures: N. Punnanithinont: None. Z. Said: None. P. Patel: None. A. Diaz: None. U. Sharma: None.
- © 2016 by American Heart Association, Inc.