title: [Prognostic evaluation of patients with systolic dysfunction: functional and echocardiographic evaluation].
abstract: OBJECTIVE
  Multiple clinical and echocardiographic parameters have been shown to have prognostic value in cases of left ventricular dysfunction. The purpose of this paper was to evaluate the relative predictive power of such parameters.
  
  
  METHODS
  Ninety-one patients with systolic dysfunction were prospectively studied. Functional status was evaluated using the New York Heart Association classification and the 6-minute walking test. Other clinical and biochemical parameters were assessed, and an anatomic and functional echocardiographic study was performed.
  
  
  RESULTS
  Mean follow-up was 16.5 months (SD: 6.95). Eighteen patients died and two underwent heart transplantation (cardiac death 22%). Multiple regression analysis showed that the only independent predictor of death was functional status. Functional classes I and II showed a 16-month mortality rate of 10%, class III 40% and class IV 83%. The mortality rate was 67% for patients who walked < 300 meters and 0% for those who reached > 500 meters. When echocardiographic results were analyzed separately, the only independent predictors of outcome were left atrial diameter and the E wave deceleration time. Deceleration times < 100 ms or atrial diameters > 5 cm were associated with a mortality rate of 46%. The correlation between E wave deceleration time and the walking test was r = 0.55, p < 0.0001.
  
  
  CONCLUSIONS
  Functional status is the main predictor of outcome in patients with systolic dysfunction, whether assessed subjectively or estimated objectively by a walking test. Among echo-Doppler parameters, the deceleration time of the E wave and left atrial diameter gave similar prognostic information, although with less statistical significance. They can confirm or substitute the prognosis obtained by the functional classification.
authors.affiliation: Complejo Hospitalario Son Dureta, Palma de Mallorca, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Alameda
authors.forename: José Luis
authors.initials: JL
authors.lastname: Moya
authors.forename: J Alberto
authors.initials: JA
authors.lastname: García Lledó
authors.forename: Manuel
authors.initials: M
authors.lastname: Alonso Recarte
authors.forename: Gabriela
authors.initials: G
authors.lastname: Guzmán
authors.forename: Celia
authors.initials: C
authors.lastname: Vaticón
authors.forename: Javier
authors.initials: J
authors.lastname: Balaguer
authors.forename: Enrique
authors.initials: E
authors.lastname: Asín
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013599:Systole; D014463:Ultrasonography