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Tissue Doppler imaging in patients with advanced heart failure: relation to functional class and prognosis.
J Heart Lung Transplant 2006; 25(2):214-8JH

Abstract

BACKGROUND

Tissue Doppler imaging (TDI) provides rapid assessment of systolic and diastolic myocardial function. However, the added value of TDI to standard Doppler echocardiographic measurements in predicting symptoms and outcome of advanced heart failure remains unknown.

METHODS

The study cohort comprised 45 patients with congestive heart failure, defined as New York Heart Association functional class III and IV, who were referred to our department for evaluation for heart transplantation. Twenty healthy subjects were the controls. Conventional echo Doppler was used to assess left ventricular (LV) ejection fraction, peak velocities of transmitral early and late diastolic LV filling, the ratio of transmitral early to late LV filling velocity, and E-deceleration time. TDI measurements recorded at the mitral annulus included systolic velocity, early and late diastolic velocities, and the ratio of early to late diastolic velocity. The ratio of transmitral early LV filling velocity to early diastolic TDI velocity of the mitral annulus (E/E') was calculated. All patients were followed for cardiac-related death and hospitalization for heart failure.

RESULTS

Patients with functional class IV had a significantly higher E/E' ratio than did patients with functional class III (12.9 +/- 2.8 vs 8.3 +/- 1.7, p < 0.001) and the controls (5.4 +/- 1.3, p < 0.001). Except for transmitral late filling velocity, all conventional echo Doppler parameters and TDI variables significantly correlated with functional class. On multivariate stepwise analysis, however, the E/E' ratio was the only independent predictor of functional class (p = 0.003). E/E' also correlated with cardiac mortality and hospitalization.

CONCLUSION

Conventional Doppler indices and TDI parameters correlated with functional class in patients with advanced heart failure. The E/E' ratio, which probably reflects high LV end-diastolic pressure, was the best measure for differentiating patients with functional class III and IV, and it also correlated with cardiac mortality and hospitalization for worsening heart failure, thereby providing additional value to standard echocardiographic measures.

Authors+Show Affiliations

Echocardiography Unit, Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. ashrafh@clalit.org.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16446223

Citation

Hamdan, Ashraf, et al. "Tissue Doppler Imaging in Patients With Advanced Heart Failure: Relation to Functional Class and Prognosis." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 25, no. 2, 2006, pp. 214-8.
Hamdan A, Shapira Y, Bengal T, et al. Tissue Doppler imaging in patients with advanced heart failure: relation to functional class and prognosis. J Heart Lung Transplant. 2006;25(2):214-8.
Hamdan, A., Shapira, Y., Bengal, T., Mansur, M., Vaturi, M., Sulkes, J., ... Sagie, A. (2006). Tissue Doppler imaging in patients with advanced heart failure: relation to functional class and prognosis. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 25(2), pp. 214-8.
Hamdan A, et al. Tissue Doppler Imaging in Patients With Advanced Heart Failure: Relation to Functional Class and Prognosis. J Heart Lung Transplant. 2006;25(2):214-8. PubMed PMID: 16446223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tissue Doppler imaging in patients with advanced heart failure: relation to functional class and prognosis. AU - Hamdan,Ashraf, AU - Shapira,Yaron, AU - Bengal,Tuvia, AU - Mansur,Mali, AU - Vaturi,Mordehay, AU - Sulkes,Jaqueline, AU - Battler,Alexander, AU - Sagie,Alex, PY - 2004/11/19/received PY - 2005/08/29/revised PY - 2005/09/05/accepted PY - 2006/2/1/pubmed PY - 2006/8/17/medline PY - 2006/2/1/entrez SP - 214 EP - 8 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 25 IS - 2 N2 - BACKGROUND: Tissue Doppler imaging (TDI) provides rapid assessment of systolic and diastolic myocardial function. However, the added value of TDI to standard Doppler echocardiographic measurements in predicting symptoms and outcome of advanced heart failure remains unknown. METHODS: The study cohort comprised 45 patients with congestive heart failure, defined as New York Heart Association functional class III and IV, who were referred to our department for evaluation for heart transplantation. Twenty healthy subjects were the controls. Conventional echo Doppler was used to assess left ventricular (LV) ejection fraction, peak velocities of transmitral early and late diastolic LV filling, the ratio of transmitral early to late LV filling velocity, and E-deceleration time. TDI measurements recorded at the mitral annulus included systolic velocity, early and late diastolic velocities, and the ratio of early to late diastolic velocity. The ratio of transmitral early LV filling velocity to early diastolic TDI velocity of the mitral annulus (E/E') was calculated. All patients were followed for cardiac-related death and hospitalization for heart failure. RESULTS: Patients with functional class IV had a significantly higher E/E' ratio than did patients with functional class III (12.9 +/- 2.8 vs 8.3 +/- 1.7, p < 0.001) and the controls (5.4 +/- 1.3, p < 0.001). Except for transmitral late filling velocity, all conventional echo Doppler parameters and TDI variables significantly correlated with functional class. On multivariate stepwise analysis, however, the E/E' ratio was the only independent predictor of functional class (p = 0.003). E/E' also correlated with cardiac mortality and hospitalization. CONCLUSION: Conventional Doppler indices and TDI parameters correlated with functional class in patients with advanced heart failure. The E/E' ratio, which probably reflects high LV end-diastolic pressure, was the best measure for differentiating patients with functional class III and IV, and it also correlated with cardiac mortality and hospitalization for worsening heart failure, thereby providing additional value to standard echocardiographic measures. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/16446223/Tissue_Doppler_imaging_in_patients_with_advanced_heart_failure:_relation_to_functional_class_and_prognosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(05)00687-X DB - PRIME DP - Unbound Medicine ER -