Value of tissue Doppler imaging for risk stratification of patients with chronic systolic heart failure with or without restrictive mitral flow

• Published in: European journal of echocardiography 2009-06, Vol.10 (4), p.562-566
• Main Authors: Dini, Frank L., Lattanzi, Fabio, Fontanive, Paolo, Rosa, Gian Marco, De Tommasi, Salvatore Mario
• Format: Article
• Language: English
• Subjects: Aged; Blood Flow Velocity; Chi-Square Distribution; Chronic Disease; Echocardiography, Doppler - methods; Female; Heart Failure, Systolic - diagnostic imaging; Heart Failure, Systolic - mortality; Humans; Kaplan-Meier Estimate; Male; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Multivariate Analysis; Prognosis; Prospective Studies; Risk Assessment - methods; Risk Factors; Statistics, Nonparametric
• ISSN: 1525-2167; 1532-2114
• DOI: 10.1093/ejechocard/jep001

Aims The aim of this study was to assess the prognostic value of tissue Doppler imaging (TDI) in patients with chronic systolic heart failure (HF) with or without restrictive mitral flow (RMF). Methods and results Echocardiograms were obtained in 378 patients with chronic systolic HF [ejection fraction (EF) ≤ 45%] in sinus rhythm. Restrictive mitral flow was defined by an E wave deceleration time (EDT) ≤ 140 ms. Tissue Doppler imaging early (E m) diastolic and systolic (S m) velocities were measured at the mitral annulus. Patients were followed-up for a median of 32 months. Endpoints were all-cause mortality and the combination of death or HF hospitalization. Mean left ventricular EF was 32 ± 8%. Restrictive mitral flow and TDI annular velocities were all univariate predictors of the endpoints. Ejection fraction 6 cm/s (log-rank: 12.73; P = 0.0004). Conclusion Doppler annular velocities provided useful information for prognostication of patients with systolic HF. Particularly, categorization of patients according to E m velocities allowed us to further stratify patients with RMF and non-RMF.