Abstract
Objectives. We sought to assess whether in clinically stable patients with chronic heart failure (CHF) the prolongation (i.e., increase) of an initially short (≤125 ms) Doppler transmittal deceleration time (DT) of early filling obtained with long-term optimal oral therapy predicts a more favorable prognosis. Background. It has been recently demonstrated that transmitral early DT is a powerful independent predictor of poor prognosis in patients with left ventricular dysfunction. However, DT may change over time according to loading conditions and medical treatment. Method. One hundred forty-four patients with CHF and a short DT (≤125 ms) underwent repeat Doppler echocardiographic study 6 months after the initial examination, while clinically stable with optimal oral therapy, and were then followed up for a mean period of 26 ± 7 months. Results. After 6 months, DT had not changed in 80 patients (group 1), whereas it was significantly prolonged (> 125 ms) in the remaining 64 patients (group 2). Baseline Doppler echocardiographic features were similar in the two groups. No changes were found after 6 months in group 1, whereas group 2 showed a slight but significant (p <0.01) reduction in end-systolic volume, an improvement in left ventricular ejection fraction (p <0.01) and a decrease (p <0.01) in the degree of tricuspid regurgitation. During follow-up, 37% of patients in group I experienced cardiac death versus 11% in group 2 (p <0.0005). By Cox model analysis, prolongation of a short DT emerged as the single best predictor of survival (chi-square 15.70). Conclusions. The prolongation of an initially short DT obtained with long-term optimal oral therapy predicts a more favorable outcome in clinically stable patients with CHF.
| Original language | English |
|---|---|
| Pages (from-to) | 1591-1597 |
| Number of pages | 7 |
| Journal | Journal of the American College of Cardiology |
| Volume | 31 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jun 1998 |
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Reversible restrictive left ventricular diastolic filling with optimized oral therapy predicts a more favorable prognosis in patients with chronic heart failure. / Temporelli, Pier L.; Corrà, Ugo; Imparato, Alessandro; Bosimini, Enzo; Scapellato, Francesco; Giannuzzi, Pantaleo.
In: Journal of the American College of Cardiology, Vol. 31, No. 7, 06.1998, p. 1591-1597.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reversible restrictive left ventricular diastolic filling with optimized oral therapy predicts a more favorable prognosis in patients with chronic heart failure
AU - Temporelli, Pier L.
AU - Corrà, Ugo
AU - Imparato, Alessandro
AU - Bosimini, Enzo
AU - Scapellato, Francesco
AU - Giannuzzi, Pantaleo
PY - 1998/6
Y1 - 1998/6
N2 - Objectives. We sought to assess whether in clinically stable patients with chronic heart failure (CHF) the prolongation (i.e., increase) of an initially short (≤125 ms) Doppler transmittal deceleration time (DT) of early filling obtained with long-term optimal oral therapy predicts a more favorable prognosis. Background. It has been recently demonstrated that transmitral early DT is a powerful independent predictor of poor prognosis in patients with left ventricular dysfunction. However, DT may change over time according to loading conditions and medical treatment. Method. One hundred forty-four patients with CHF and a short DT (≤125 ms) underwent repeat Doppler echocardiographic study 6 months after the initial examination, while clinically stable with optimal oral therapy, and were then followed up for a mean period of 26 ± 7 months. Results. After 6 months, DT had not changed in 80 patients (group 1), whereas it was significantly prolonged (> 125 ms) in the remaining 64 patients (group 2). Baseline Doppler echocardiographic features were similar in the two groups. No changes were found after 6 months in group 1, whereas group 2 showed a slight but significant (p <0.01) reduction in end-systolic volume, an improvement in left ventricular ejection fraction (p <0.01) and a decrease (p <0.01) in the degree of tricuspid regurgitation. During follow-up, 37% of patients in group I experienced cardiac death versus 11% in group 2 (p <0.0005). By Cox model analysis, prolongation of a short DT emerged as the single best predictor of survival (chi-square 15.70). Conclusions. The prolongation of an initially short DT obtained with long-term optimal oral therapy predicts a more favorable outcome in clinically stable patients with CHF.
AB - Objectives. We sought to assess whether in clinically stable patients with chronic heart failure (CHF) the prolongation (i.e., increase) of an initially short (≤125 ms) Doppler transmittal deceleration time (DT) of early filling obtained with long-term optimal oral therapy predicts a more favorable prognosis. Background. It has been recently demonstrated that transmitral early DT is a powerful independent predictor of poor prognosis in patients with left ventricular dysfunction. However, DT may change over time according to loading conditions and medical treatment. Method. One hundred forty-four patients with CHF and a short DT (≤125 ms) underwent repeat Doppler echocardiographic study 6 months after the initial examination, while clinically stable with optimal oral therapy, and were then followed up for a mean period of 26 ± 7 months. Results. After 6 months, DT had not changed in 80 patients (group 1), whereas it was significantly prolonged (> 125 ms) in the remaining 64 patients (group 2). Baseline Doppler echocardiographic features were similar in the two groups. No changes were found after 6 months in group 1, whereas group 2 showed a slight but significant (p <0.01) reduction in end-systolic volume, an improvement in left ventricular ejection fraction (p <0.01) and a decrease (p <0.01) in the degree of tricuspid regurgitation. During follow-up, 37% of patients in group I experienced cardiac death versus 11% in group 2 (p <0.0005). By Cox model analysis, prolongation of a short DT emerged as the single best predictor of survival (chi-square 15.70). Conclusions. The prolongation of an initially short DT obtained with long-term optimal oral therapy predicts a more favorable outcome in clinically stable patients with CHF.
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U2 - 10.1016/S0735-1097(98)00165-X
DO - 10.1016/S0735-1097(98)00165-X
M3 - Article
C2 - 9626839
AN - SCOPUS:0031779651
VL - 31
SP - 1591
EP - 1597
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 7
ER -