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Independence of restrictive filling pattern and LV ejection fraction with mortality in heart failure: An individual patient meta‐analysis
Author(s) -
R. Doughty,
Klein Al,
Poppe Kk,
Greg Gamble,
Fl Dini,
Jacob Eifer Møller,
M Betancor Quintana,
CM Yu,
Gillian A. Whalley
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.06.005
Subject(s) - medicine , ejection fraction , cardiology , heart failure , hazard ratio , ventricular filling , risk stratification , doppler echocardiography , confidence interval , diastole , blood pressure
Background: The Doppler echocardiographic restrictive mitral filling pattern (RFP) is an important prognostic indicator in patients with heart failure (HF), but the interaction between RFP, left ventricular ejection fraction (LVEF) and filling pattern remains uncertain. Aims: To determine whether the RFP is predictive of mortality independently of LVEF in patients with HF. Methods: Online databases were searched to identify studies assessing the relationship between prognosis and LV filling pattern in patients with HF. Individual patient data from 18 studies (3540 patients) were extracted and collated at the MeRGE Coordinating Centre (The University of Auckland). Results: Overall, RFP was associated with higher all‐cause mortality than the non‐restrictive filling pattern: hazard ratio 2.42 (95% CI 2.06, 2.83). In multivariable analysis the RFP, LVEF, NYHA class and age were independent predictors of mortality. The prevalence of the RFP was inversely related to LVEF but remained a predictor of mortality even in those patients with preserved LVEF. Conclusions: The restrictive mitral filling pattern is a powerful predictor of mortality, independent of LVEF and age, in patients with HF. Doppler‐derived LV filling patterns are an accessible marker from echocardiography that can readily be incorporated in risk stratification of all patients with HF.