Echocardiographic ejection fraction in patients with acute heart failure: correlations with hemodynamic, clinical, and neurohormonal measures and short-term outcome.
BACKGROUND
Although echocardiographic ejection fraction (EF) is frequently used for the estimation of left ventricular contractility in patients with acute heart failure, its exact role and correlations with clinical, hemodynamic, and neurohormonal variables of cardiac contractility is not known.


METHODS
Patients (343) with acute heart failure, enrolled into two prospective placebo-controlled hemodynamic studies of tezosentan, and in whom EF was available at baseline, were included. Outcome was evaluated in a subset of 94 patients who were enrolled in the placebo arms of the studies.


RESULTS
Higher echocardiographic EF was correlated with older age, increased incidence of hypertension and atrial fibrillation, and female gender. We observed weak correlation between EF and cardiac output or cardiac power and no correlation with wedge pressure, and the change in hemodynamic variables over time. Higher EF was correlated with more baseline leukocytosis and higher plasma levels of endothelin-1 and blood urea nitrogen, while lower EF was related to higher baseline B-type natriuretic peptide (BNP). We observed no overall correlations between EF and outcome.


CONCLUSIONS
In patients with acute heart failure, echocardiographic EF is weakly correlated with hemodynamic measures of left ventricular contractility and outcome; hence, it should be interpreted cautiously when evaluating patients admitted due to acute heart failure.
Uriel
Nir
N
The Cardiology Department, Assaf-Harofeh Medical Center, 70300, Zerifin, Israel.
Torre-Amione
Guillermo
G
Milo
Olga
O
Kaluski
Edo
E
Perchenet
Loïc
L
Blatt
Alex
A
Kobrin
Isaac
I
Turnovski
Arkadi
A
Kaplan
Shoshana
S
Rainisio
Maurizio
M
Frey
Aline
A
Vered
Zvi
Z
Cotter
Gad
G
D000368:Aged; D001806:Blood Urea Nitrogen; D002302:Cardiac Output; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography
D019332:Endothelin-1