Left ventricular systolic ejection time is an independent predictor of all-cause mortality in heart failure with reduced ejection fraction
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Left ventricular systolic ejection time is an independent predictor of all-cause mortality in heart failure with reduced ejection fraction. / Alhakak, Alia S.; Sengelov, Morten; Jørgensen, Peter G.; Bruun, Niels E.; Johnsen, Cecilie; Abildgaard, Ulrik; Iversen, Allan Z.; Hansen, Thomas F.; Teerlink, John R.; Malik, Fady I.; Solomon, Scott D.; Gislason, Gunnar; Biering-Sorensen, Tor.
In: European Journal of Heart Failure, Vol. 23, No. 2, 2021, p. 240-249.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Left ventricular systolic ejection time is an independent predictor of all-cause mortality in heart failure with reduced ejection fraction
AU - Alhakak, Alia S.
AU - Sengelov, Morten
AU - Jørgensen, Peter G.
AU - Bruun, Niels E.
AU - Johnsen, Cecilie
AU - Abildgaard, Ulrik
AU - Iversen, Allan Z.
AU - Hansen, Thomas F.
AU - Teerlink, John R.
AU - Malik, Fady I.
AU - Solomon, Scott D.
AU - Gislason, Gunnar
AU - Biering-Sorensen, Tor
PY - 2021
Y1 - 2021
N2 - Aims Colour tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to obtain cardiac time intervals including isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and systolic ejection time (SET). The myocardial performance index (MPI) is defined as [(IVCT + IVRT)/SET]. Whether cardiac time intervals obtained by the TDI M-mode method can be used to predict outcome in patients with heart failure with reduced ejection fraction (HFrEF) remains unknown.Methods and results A total of 997 patients with HFrEF (mean age 67 +/- 11 years, 74% male) underwent an echocardiographic examination including TDI. During a median follow-up of 3.4 years (interquartile range 1.9-4.8 years), 165 (17%) patients died. The risk of mortality increased by 9% per 10 ms decrease in SET [per 10 ms decrease: hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.06-1.13; P <0.001]. The association remained significant even after multivariable adjustment for clinical and echocardiographic parameters (per 10 ms decrease: HR 1.06, 95% CI 1.01-1.11; P = 0.030). The MPI was a significant predictor in an unadjusted model (per 0.1 increase: HR 3.06, 95% CI 1.16-8.06; P = 0.023). However, the association did not remain significant after multivariable adjustment. No significant associations between IVCT or IVRT and mortality were found in unadjusted nor adjusted models. Additionally, SET provided incremental prognostic information with regard to predicting mortality when added to established clinical predictors of mortality in patients with HFrEF.Conclusion In patients with HFrEF, SET provides independent and incremental prognostic information regarding all-cause mortality.
AB - Aims Colour tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to obtain cardiac time intervals including isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and systolic ejection time (SET). The myocardial performance index (MPI) is defined as [(IVCT + IVRT)/SET]. Whether cardiac time intervals obtained by the TDI M-mode method can be used to predict outcome in patients with heart failure with reduced ejection fraction (HFrEF) remains unknown.Methods and results A total of 997 patients with HFrEF (mean age 67 +/- 11 years, 74% male) underwent an echocardiographic examination including TDI. During a median follow-up of 3.4 years (interquartile range 1.9-4.8 years), 165 (17%) patients died. The risk of mortality increased by 9% per 10 ms decrease in SET [per 10 ms decrease: hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.06-1.13; P <0.001]. The association remained significant even after multivariable adjustment for clinical and echocardiographic parameters (per 10 ms decrease: HR 1.06, 95% CI 1.01-1.11; P = 0.030). The MPI was a significant predictor in an unadjusted model (per 0.1 increase: HR 3.06, 95% CI 1.16-8.06; P = 0.023). However, the association did not remain significant after multivariable adjustment. No significant associations between IVCT or IVRT and mortality were found in unadjusted nor adjusted models. Additionally, SET provided incremental prognostic information with regard to predicting mortality when added to established clinical predictors of mortality in patients with HFrEF.Conclusion In patients with HFrEF, SET provides independent and incremental prognostic information regarding all-cause mortality.
KW - Cardiac time intervals
KW - Heart failure
KW - Mortality
KW - Tissue Doppler echocardiography
KW - IMAGING M-MODE
KW - MYOSIN ACTIVATION
KW - CARDIAC-FUNCTION
KW - TEI-INDEX
KW - INTERVALS
KW - ASSOCIATION
KW - GUIDELINES
KW - PHASE-2
KW - DEATH
U2 - 10.1002/ejhf.2022
DO - 10.1002/ejhf.2022
M3 - Journal article
C2 - 33034122
VL - 23
SP - 240
EP - 249
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 2
ER -
ID: 251587812