title: Reversible left ventricular diastolic dysfunction on Doppler tissue imaging predicts a more favorable prognosis in chronic heart failure.
abstract: BACKGROUND
  Early (e')/late (a') diastolic mitral annular velocity ratio is a powerful independent predictor of poor prognosis in patients with left ventricular (LV) dysfunction. Doppler tissue imaging, however, may change over time according to intervention and medical treatment. The aim of the present study was to prospectively evaluate whether, in clinically stable patients with chronic heart failure (CHF), the decrease of an initially high e'/a' ratio on long-term therapy predicts a more favorable outcome.
  
  
  RESULTS
  One hundred and eighty-one adult patients with CHF and high e'/a' ratio (≥ 0.74) underwent repeat echocardiography 6 months after the initial examination, and were then followed up for a mean period of 20 months. After 6 months, e'/a' ratio did not change in 95 patients, whereas it was significantly decreased (<0.74) in the remaining 86 patients. During follow-up, 55 participants (30%) had cardiac events. According to multivariate Cox regression analysis, decrease in e'/a' ratio, initial New York Heart Association class III or IV, and change in LV mass index as well as in systolic mitral annular velocities emerged as independent predictors of survival.
  
  
  CONCLUSIONS
  The decrease of an initially high e'/a' ratio on long-term therapy predicts a more favorable outcome in clinically stable patients with CHF.
authors.affiliation: Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, 105 Taiwan. chl5265@gmail.com
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.forename: Shang-Hung
authors.initials: SH
authors.lastname: Chang
authors.forename: Fun-Chung
authors.initials: FC
authors.lastname: Lin
authors.forename: Ming-Jer
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chen
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Chu
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: Delon
authors.initials: D
authors.lastname: Wu
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy