HEART FAILURE AND CARDIOMYOPATHY

Ventricular long-axis function is of major importance for long-term survival in patients with heart failure

B Grüner Sveälv, E L Olofsson, B Andersson

Department of Molecular and Clinical Medicine/Cardiology, Wallenberg Laboratory, Sahlgrenska Academy at Göteborg University, Sweden

Dr B Andersson, Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; bert.andersson{at}wlab.gu.se

Objective: To assess the importance of ventricular systolic and diastolic long-axis (LAX) function in comparison with short-axis (SAX) function for prediction of long-term survival in patients with heart failure.

Design: Prospective epidemiological study.

Setting: University and county hospital.

Patients and methods: Patients with idiopathic heart failure (n = 228), not older than 65 years, mean (SD) ejection fraction 44 (17)%, were investigated with echocardiography in the SAX and in the LAX basal parts of the right and left ventricle. Patients were followed up for 10 years with respect to total survival or heart transplantation.

Results: Left ventricular (LV) LAX systolic amplitude was a strong risk predictor of long-term survival (p<0.001). In a multivariate Cox proportional hazard analysis, adjusting for age, gender, heart rate, systolic blood pressure, and SAX fractional shortening, LAX systolic amplitude was the only independent predictor of outcome (hazard ratio = 0.89 (95% CI 0.80 to 0.98), p = 0.02). Survival curves for each quartile of LAX systolic amplitude differentiated between mild, moderate and severe dysfunction in relation to outcome (p<0.001). There was a significant correlation between SAX and LAX ventricular function only in the lower range of LAX systolic amplitude (<6.8 mm).

Conclusions: LV LAX systolic amplitude independently predicted survival, after adjustment for clinical variables and LV SAX function. These data further emphasise the importance of the basal parts of the ventricles for ventricular function and thereby long-term outcome.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Left and right ventricular long-axis function and prognosis

John E Sanderson
Heart 2008 94: 262-263. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Cho, G.-Y., Marwick, T. H., Kim, H.-S., Kim, M.-K., Hong, K.-S., Oh, D.-J. (2009). Global 2-dimensional strain as a new prognosticator in patients with heart failure.. J Am Coll Cardiol 54: 618-624 [Abstract] [Full Text]  

eLetters:

Read all eLetters

Prognostic value of left ventricular long-axis versus short-axis systolic function in heart failure

Piercarlo Ballo, et al.

Online, 26 Nov 2007 [Full text]

Authors Response

Bente Grüner Sveälv, et al.

Online, 26 Nov 2007 [Full text]