Prognostic importance of tissue Doppler-derived diastolic function in patients presenting with acute coronary syndrome: a bedside echocardiographic study

Aims We sought to evaluate the prognostic value of bedside tissue Doppler derived diastolic function in patients presenting with acute coronary syndrome (ACS) on top of major clinical predictors of mortality and routine laboratory testings. Methods and results Bedside Doppler echocardiography and la...

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Published in:European journal of echocardiography 2008-09, Vol.9 (5), p.594-598
Main Authors: Richardson-Lobbedez, Marjorie, Maréchaux, Sylvestre, Bauters, Christophe, Darchis, Julie, Auffray, Jean Luc, Bauchart, Jean Jacques, Aubert, Jean Marc, LeJemtel, Thierry H., Lesenne, Martine, Van Belle, Eric, Goldstein, Patrick, Asseman, Philippe, Ennezat, Pierre V.
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - diagnostic imaging
Acute Coronary Syndrome - mortality
Acute Coronary Syndrome - physiopathology
Diastole
Echocardiography, Doppler - methods
Female
Humans
Length of Stay
Male
Middle Aged
Prognosis
Prospective Studies
Stroke Volume
Survival Analysis
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Summary:Aims We sought to evaluate the prognostic value of bedside tissue Doppler derived diastolic function in patients presenting with acute coronary syndrome (ACS) on top of major clinical predictors of mortality and routine laboratory testings. Methods and results Bedside Doppler echocardiography and laboratory tests were prospectively performed in 239 consecutive patients (mean age 62 ± 14, 69% men) admitted for ACS. Ratio of early transmitral flow (E) to early mitral annulus velocities (e′) was calculated. The study endpoint was cardiac death. The median follow-up period was 2 years. E/e′ was >15 in 39 patients. Multivariate predictors of E/e′ > 15 were older age, diabetes, non-ST-segment elevation ACS, and decreased LV ejection fraction (LVEF). Survival free from cardiac death was lower in patients with E/e′ ratio >15 (P = 0.01). History of coronary artery disease, lower creatinine clearance, higher glycemia on admission, decreased LVEF, and E/e′ >15 were independent predictors of cardiac death. Conclusion Bedside Doppler echocardiography provides prognostic information on top of major clinical predictors of mortality and routine laboratory testings in patients presenting with ACS.
ISSN:1525-2167
1532-2114
DOI:10.1093/ejechocard/jen005