Ventricular long-axis function is of major importance for long-term survival in patients with heart failure.
OBJECTIVE
To assess the importance of ventricular systolic and diastolic long-axis (LAX) function in comparison with short-axis (SAX) function for prediction of long-term survival in patients with heart failure.


METHODS
Prospective epidemiological study.


METHODS
University and county hospital.


METHODS
Patients with idiopathic heart failure (n = 228), not older than 65 years, mean (SD) ejection fraction 44 (17)%, were investigated with echocardiography in the SAX and in the LAX basal parts of the right and left ventricle. Patients were followed up for 10 years with respect to total survival or heart transplantation.


RESULTS
Left ventricular (LV) LAX systolic amplitude was a strong risk predictor of long-term survival (p<0.001). In a multivariate Cox proportional hazard analysis, adjusting for age, gender, heart rate, systolic blood pressure, and SAX fractional shortening, LAX systolic amplitude was the only independent predictor of outcome (hazard ratio = 0.89 (95% CI 0.80 to 0.98), p = 0.02). Survival curves for each quartile of LAX systolic amplitude differentiated between mild, moderate and severe dysfunction in relation to outcome (p<0.001). There was a significant correlation between SAX and LAX ventricular function only in the lower range of LAX systolic amplitude (<6.8 mm).


CONCLUSIONS
LV LAX systolic amplitude independently predicted survival, after adjustment for clinical variables and LV SAX function. These data further emphasise the importance of the basal parts of the ventricles for ventricular function and thereby long-term outcome.
Sveälv
B Grüner
BG
Department of Molecular and Clinical Medicine/Cardiology, Wallenberg Laboratory, Sahlgrenska Academy at Göteborg University, Sweden.
Olofsson
E L
EL
Andersson
B
B
D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology