Mitral peak early diastolic filling velocity to deceleration time ratio as a predictor of prognosis in patients with chronic heart failure and preserved or reduced ejection fraction.
OBJECTIVE
Doppler derived mitral peak early diastolic filling velocity to deceleration time ratio (E/DT) has been proposed as parameter for predicting prognosis in general population. This study prospectively investigates the incremental prognostic value of E/DT over clinical, conventional echocardiographic and mitral-Doppler variables in patients hospitalized for decompensated heart failure (HF).


METHODS
We analyzed 95 HF patients (mean age 64.8 ± 12.2 years) hospitalized at our institution from January 2010 to March 2012. The primary end-point was cardiac death or hospitalization, whichever occurred first. Cox regression analysis was performed to identify significant predictors of outcomes.


RESULTS
During follow-up (median 37.7 months) 13 patients died and 44 were hospitalized for a cardiac event. At univariable analysis, New York Heart Association (NYHA) functional class, furosemide dosage, lateral tricuspidal annular plane systolic excursion, deceleration time and E/DT were predictive of outcome. At multivariable analysis, E/DT was the only predictor of prognosis (hazard ratio = 1.02, P = 0.018), giving incremental prognostic information to clinical and other echocardio-graphic measures (global chi-square from 15.4 to 25.2; P = 0.032).


CONCLUSIONS
E/DT gives independent and incremental prognostic information in HF patients.
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Flora
F
Pirozzi
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Antonella
A
Paglia
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Laura
L
Sasso
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Pasquale
P
Abete
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Angelo
A
Carlomagno
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Carlo G
CG
Tocchetti
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Domenico
D
Bonaduce
Department of Translational Medical Sciences, Section of Internal Medicine, Federico II University, Naples, Italy.
Mario
M
Petretta
Echocardiographic evaluation; Left ventricular function; Risk stratification