title: Additional Prognostic Value of EAS index in predicting the occurrence of rehospitalizations in chronic heart failure: data from the Daunia Heart Failure Registry.
abstract: BACKGROUND
  Tissue Doppler imaging (TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure (CHF). The clinical role of newly developed TDI parameters, however, still needs to be documented.
  
  
  METHODS
  A total of 287 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and were followed prospectively for a median 255 (204-316) days. Conventional echocardiography and TDI parameters were calculated. We also quantified by TDI a combined index (EAS index) of diastolic and systolic performance E'/(A'xS') and assessed its possible additional prognostic role in combination with 'traditional' parameters such as left ventricular ejection fraction (LVEF) and myocardial performance index (MPI).
  
  
  RESULTS
  Subjects readmitted for worsening HF were characterized by higher levels of EAS index (median 0·14 (95% C.I. 0·12-0·21) vs. 0·11 (0·10-0·12, P < 0·05)). Increased rates of rehospitalization were found in subjects with EAS index >median (0·115) (21% vs. 10%, P < 0·05); higher EAS index values predicted the incidence of readmissions for worsening HF during follow-up, even at multivariable analysis. The assessment of EAS index in addition to LVEF and MPI showed an adjunctive prognostic value (log-rank P < 0·001 and P < 0·05, respectively).
  
  
  CONCLUSIONS
  EAS index assessed by TDI may be helpful in predicting the risk of rehospitalizations in subjects with CHF. EAS index may represent an independent adjunctive tool for the risk stratification of patients with CHF in addition to 'traditional' tools such as LVEF or MPI.
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Correale
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Totaro
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Ferraretti
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Musaico
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Passero
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: De Rosa
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Abruzzese
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ieva
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: Cardiology Department, University of Foggia, Foggia, Italy.
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology
keywords: Chronic Heart Failure; EAS index; echocardiography; prognosis; tissue doppler imaging