title: Prognostic importance of tissue Doppler-derived diastolic function in patients presenting with acute coronary syndrome: a bedside echocardiographic study.
abstract: OBJECTIVE
  We sought to evaluate the prognostic value of bedside tissue Doppler derived diastolic function in patients presenting with acute coronary syndrome (ACS) on top of major clinical predictors of mortality and routine laboratory testings.
  
  
  RESULTS
  Bedside Doppler echocardiography and laboratory tests were prospectively performed in 239 consecutive patients (mean age 62 +/- 14, 69% men) admitted for ACS. Ratio of early transmitral flow (E) to early mitral annulus velocities (e') was calculated. The study endpoint was cardiac death. The median follow-up period was 2 years. E/e' was >15 in 39 patients. Multivariate predictors of E/e' > 15 were older age, diabetes, non-ST-segment elevation ACS, and decreased LV ejection fraction (LVEF). Survival free from cardiac death was lower in patients with E/e' ratio >15 (P = 0.01). History of coronary artery disease, lower creatinine clearance, higher glycemia on admission, decreased LVEF, and E/e' >15 were independent predictors of cardiac death.
  
  
  CONCLUSIONS
  Bedside Doppler echocardiography provides prognostic information on top of major clinical predictors of mortality and routine laboratory testings in patients presenting with ACS.
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Intensive Care Unit, Lille F-59019, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Richardson-Lobbedez
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Maréchaux
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
authors.forename: Julie
authors.initials: J
authors.lastname: Darchis
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Auffray
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Bauchart
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Aubert
authors.forename: Thierry H
authors.initials: TH
authors.lastname: LeJemtel
authors.forename: Martine
authors.initials: M
authors.lastname: Lesenne
authors.forename: Eric
authors.initials: E
authors.lastname: Van Belle
authors.forename: Patrick
authors.initials: P
authors.lastname: Goldstein
authors.forename: Philippe
authors.initials: P
authors.lastname: Asseman
authors.forename: Pierre V
authors.initials: PV
authors.lastname: Ennezat
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016019:Survival Analysis