Clinical Investigations: Congestive Heart FailureDeceleration time of early filling in patients with left ventricular systolic dysfunction: Functional and prognostic independent value☆,☆☆
Section snippets
Study population
Sixty consecutive patients with NYHA class II-IV chronic heart failure symptoms and moderate to severe left ventricular (LV) dysfunction (ejection fraction <40% by radionuclide ventriculography) were included between January 1996 and November 1997 and were prospectively studied in our heart failure unit. Patients were not considered for inclusion if they had sustained ventricular tachyarrhythmias (n = 2) or any severe systemic disease (n = 2) that might shorten survival. Six patients with
Prediction of functional capacity
Results of Doppler-echocardiography, radionuclide ventriculography, cardiopulmonary exercise testing and hemodynamic studies are summarized in Table II.
The better univariate correlations with peak Vo2 were found for DT (r = 0.65, P <.001; Figure 1) and for NYHA functional class (r = 0.64, P <.001) as it is reflected in Table III.There was a moderate relationship between peak Vo2 and radionuclide ejection fraction (r = 0.5, P <.01). Lower but significant
Discussion
The present study demonstrates the importance of diastolic function in patients with congestive heart failure and depressed LV systolic function, with special focus on a simple parameter of Doppler echocardiography such as DT. Among a wide variety of variables, DT independently predicts functional capacity and prognosis in these patients. The information provided by this parameter, specially when combined with that of peak Vo2, allows for the stratification of patients with LV systolic
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Cited by (16)
The prognostic significance of restrictive diastolic filling associated with heart failure: A meta-analysis
2007, International Journal of CardiologyCitation Excerpt :Despite repeated attempts, confirmation was not possible for 7 studies [5,10,16,17,19,22,39]. Of these, 6 studies clearly reported numbers in the publication [5,10,16,17,19,22] and these unconfirmed numbers were used in the analysis, the remaining one study may have been eligible but was not included [39]. One author combined the results of two studies to exclude overlapping patients [32,33].
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2004, American Journal of CardiologyCitation Excerpt :In the present study, left atrial volume had reasonable sensitivity for CHF, but had low specificity, consistent with previous data indicating that patients with reduced ejection fraction may have enlarged atria independent of left ventricular filling pressure.16 Previous studies have demonstrated the value of conventional Doppler (mitral inflow and pulmonary venous parameters) in detecting elevated left ventricular filling pressures.14,23,24 Yamamoto et al18 and Ommen et al7 demonstrated that conventional Doppler is accurate in patients with reduced ejection fraction, but inaccurate in patients with normal ejection fraction.
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Reprint requests: Francisco J. Morales, MD, Servicio de Cardiología, Hospital Universitario Puerto Real, Carretera Nacional IV, Km 665, Puerto Real (Cádiz), Spain.
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E-mail: [email protected]