Left ventricular dysfunction and mortality in adult patients with Eisenmenger syndrome.
OBJECTIVE
To identify risk factors associated with mortality in adult patients with Eisenmenger syndrome and to assess the effect of left ventricular dysfunction on mortality in these patients.


RESULTS
One hundred twenty-two adult patients with Eisenmenger syndrome were retrospectively evaluated for signs and symptoms of heart failure, and underwent electrocardiography and laboratory investigations. Available echocardiograms were analyzed and left ventricular function was assessed both qualitatively and quantitatively. There were 47 deaths at 37.8 +/- 12.0 years of age. On univariate analysis clinical signs and symptoms of heart failure, right ventricular hypertrophy on electrocardiography, wide QRS (QRS duration >130 milliseconds), and left ventricular dysfunction (left ventricular ejection fraction [LVEF] <50%) on echocardiography were associated with mortality. On multivariate analysis, signs and symptoms of heart failure, right ventricular hypertrophy on electrocardiography, and LVEF <50% remained strong predictors of death.


CONCLUSIONS
Signs and symptoms of heart failure predict mortality in patients with Eisenmenger syndrome. Furthermore, patients with left ventricular dysfunction (LVEF <50%) have higher mortality. A combination of signs and symptoms of heart failure, right ventricular hypertrophy on electrocardiography, and left ventricular dysfunction on echocardiography provides the most powerful predictor of death in patients with Eisenmenger syndrome.
Salehian
Omid
O
McMaster University, Department of Medicine, Hamilton, Ontario, Canada. salehian@hhsc.ca
Schwerzmann
Markus
M
Rambihar
Sherryn
S
Silver
Deborah
D
Siu
Sam
S
Webb
Gary
G
Liu
Peter
P
D000328:Adult; D015331:Cohort Studies; D004452:Echocardiography; D004541:Eisenmenger Complex / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000150:complications / Q000175:diagnosis; D053208:Kaplan-Meier Estimate; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis