Prognostic importance of tissue Doppler-derived diastolic function in patients presenting with acute coronary syndrome: a bedside echocardiographic study.
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.
Richardson-Lobbedez
Marjorie
M
Centre Hospitalier Régional et Universitaire de Lille, Intensive Care Unit, Lille F-59019, France.
Maréchaux
Sylvestre
S
Bauters
Christophe
C
Darchis
Julie
J
Auffray
Jean Luc
JL
Bauchart
Jean Jacques
JJ
Aubert
Jean Marc
JM
LeJemtel
Thierry H
TH
Lesenne
Martine
M
Van Belle
Eric
E
Goldstein
Patrick
P
Asseman
Philippe
P
Ennezat
Pierre V
PV
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