Reversible Left Ventricular Diastolic Dysfunction on Doppler Tissue Imaging Predicts a More Favorable Prognosis in Chronic Heart Failure

Cheng-Hung Lee; Kuo-Chun Hung; Shang-Hung Chang; Fun-Chung Lin; Ming-Jer Hsieh; Chun-Chi Chen; Chi-Ming Chu; I-Chang Hsieh; Ming-Shien Wen; Delon Wu

doi:10.1253/circj.CJ-11-0929

Heart Failure

Reversible Left Ventricular Diastolic Dysfunction on Doppler Tissue Imaging Predicts a More Favorable Prognosis in Chronic Heart Failure

Cheng-Hung Lee, Kuo-Chun Hung, Shang-Hung Chang, Fun-Chung Lin, Ming-Jer Hsieh, Chun-Chi Chen, Chi-Ming Chu, I-Chang Hsieh, Ming-Shien Wen, Delon Wu

Author information

Cheng-Hung Lee
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Kuo-Chun Hung
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Shang-Hung Chang
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Fun-Chung Lin
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Ming-Jer Hsieh
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Chun-Chi Chen
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Chi-Ming Chu
Section of Heath Informatics, Institute of Public Health, National Defense Medical Centre and University
I-Chang Hsieh
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Ming-Shien Wen
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine
Delon Wu
Second Section of Cardiology, Department of Internal Medicine, Heart Failure Center, Chang Gung Memorial Hospital, Linkou, and Chang Gung University College of Medicine

Keywords: Doppler tissue imaging change, Heart failure

JOURNAL FREE ACCESS

2012 Volume 76 Issue 5 Pages 1145-1150

DOI https://doi.org/10.1253/circj.CJ-11-0929

View "Advance Publication" version (February 22, 2012).

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Abstract

Background: Early (e')/late (a') diastolic mitral annular velocity ratio is a powerful independent predictor of poor prognosis in patients with left ventricular (LV) dysfunction. Doppler tissue imaging, however, may change over time according to intervention and medical treatment. The aim of the present study was to prospectively evaluate whether, in clinically stable patients with chronic heart failure (CHF), the decrease of an initially high e'/a' ratio on long-term therapy predicts a more favorable outcome. Methods and Results: One hundred and eighty-one adult patients with CHF and high e'/a' ratio (≥0.74) underwent repeat echocardiography 6 months after the initial examination, and were then followed up for a mean period of 20 months. After 6 months, e'/a' ratio did not change in 95 patients, whereas it was significantly decreased (<0.74) in the remaining 86 patients. During follow-up, 55 participants (30%) had cardiac events. According to multivariate Cox regression analysis, decrease in e'/a' ratio, initial New York Heart Association class III or IV, and change in LV mass index as well as in systolic mitral annular velocities emerged as independent predictors of survival. Conclusions: The decrease of an initially high e'/a' ratio on long-term therapy predicts a more favorable outcome in clinically stable patients with CHF. (Circ J 2012; 76: 1145-1150)

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