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

Bente Grüner Sveälv ^1*, Eva Lavik Olofsson ¹ and Bert Andersson ¹

¹ Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Sweden

^* To whom correspondence should be addressed. E-mail: bente{at}wlab.gu.se.

Accepted 13 March 2007

Abstract

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, 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 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<0.0001). 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, HR 0.89 [0.80-0.98], p=0.02. Survival curves for each quartile of LAX systolic amplitude differentiated between mild, moderate and severe dysfunction in relation to outcome (p=0.0007). 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, also 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.

Keywords Echocardiography, heart decompensation, atrial fibrillations, prognosis, mortality.

Keywords: Atrial fibrillation, Echocardiography, Heart decompensation, Mortality, Prognosis

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