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Prognostic Role of Myocardial Performance Index on Long‐Term Survival after Heart Transplantation: A Prospective Study
Author(s) -
Frea Simone,
Capriolo Michele,
Bergamasco Laura,
Iacovino Cristina,
Quaglia Francesca Calì,
Ribezzo Marco,
Marra Walter Grosso,
Boffini Massimo,
Rinaldi Mauro,
Morello Mara,
Gaita Fiorenzo
Publication year - 2013
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12220
Subject(s) - mace , medicine , heart transplantation , cardiology , prospective cohort study , confidence interval , transplantation , receiver operating characteristic , heart failure , myocardial infarction , percutaneous coronary intervention
The survival rate of heart transplant patients is increasing, underlying the need for accurate predictors of adverse events during clinical follow‐up. Myocardial performance index ( MPI ) is a Doppler‐derived index of combined systolic and diastolic function: we assessed the prognostic role of MPI in survival of patients >1 year after heart transplantation ( HT ). A total of 152 consecutive HT patients referred to our institution were enrolled in this prospective study. Primary endpoints were cardiac death and a composite of major adverse cardiac events ( MACE ). During follow‐up (69 ± 22 months), 68 (44.7%) patients had an adverse event and 20 (13.15%) patients died. Patients with MACE during follow‐up showed lower EF (57.3 ± 9.3 vs. 63 ± 6.1; P < 0.001) and higher MPI (0.45 ± 0.19 vs. 0.31 ± 0.13; P < 0.001) at enrolment. MPI and EF were independently related to MACE ( OR = 2.2; 95% confidence interval [ CI ] = 1.01–5.1; and OR = 6.6; 95% CI = 3.5–11.2, respectively) and showed strong diagnostic power ( MPI : receiver operating characteristic [ ROC ] area = 79%, with 79% sensitivity and 81% specificity; EF : ROC area = 77%, with 54% sensitivity and 91% specificity) in the subsequent year. Patients with EF > 50% and MPI < 0.45 at enrolment showed 75% event‐free survival 5 years after HT . In HT patients, MPI combined with EF was an accurate means of predicting long‐term adverse events.