Spherical ventricular chamber is a predictor of poor prognosis of heart failure with preserved ejection fraction

Abstract

Purpose: Although heart failure (HF) with preserved left ventricular (LV) ejection fraction (HFPEF) is present in 40-50% of HF patients, echocardiographic prognostic predictors have not been well investigated. The LV chamber usually shows geometrical remodeling from ellipse to sphere as HF advances. Thus, we retrospectively analyzed the data to assess the value of analysis of LV geometrical characteristics in patients with HFPEF. Subjects and Methods: A total of 52 patients with HFPEF (ejection fraction>=50%) were enrolled and studied. An echocardiographic examination was performed on admission and repeated after optimized medical therapy. Echocardiography was used to measure sphericity index (SI) as a ratio of LV radial to longitudinal dimension at discharge. Cardiac events included death and re-hospitalization for worsening of HF. Results and Discussion: There were 14 cardiac events during a mean follow-up period of 690 days. Patients with spherical LV (SI<=1.7) showed significantly lower event-free survival than patients with ellipsoid LV (SI⟩1.7) (log-rank, p⟨0.05). According to multivariate logistic regression analysis, SI<=1.7 was the only independent predictor of death and re-hospitalization for worsening of HF. Conclusion: Spherical LV chamber may be predictive of poor prognosis of HFPEF.