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Peak Myocardial Acceleration during Isovolumic Relaxation Time Predicts the Occurrence of Rehospitalization in Chronic Heart Failure: Data from the Daunia Heart Failure Registry
Author(s) -
Correale Michele,
Totaro Antonio,
Ferraretti Armando,
Passero Tommaso,
Rosa Fiorella,
Musaico Francesco,
Ieva Riccardo,
Biase Matteo Di,
Brunetti Natale Daniele
Publication year - 2014
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.12390
Subject(s) - medicine , heart failure , cardiology , ejection fraction , isovolumic relaxation time , confidence interval , isovolumetric contraction , doppler echocardiography , diastole , blood pressure
Background Tissue Doppler imaging ( TDI ) may be useful in identifying subjects at higher risk among patients with chronic heart failure ( CHF ). The clinical role of new developed TDI parameters, however, still needs to be documented. Methods A total of 113 consecutive patients with CHF enrolled in the Daunia heart failure registry underwent echocardiography assessment and were followed prospectively for 234 ± 262 days. Conventional echocardiography and TDI parameters were calculated. We also calculated peak myocardial acceleration during isovolumic relaxation time ( pIVA [r]) derived from TDI ( pIVV (r)/AT). Results Subjects readmitted for worsening HF were characterized by lower levels of pIVA (r) (0.8 ± 0.3 vs. 1.3 ± 0.5 m/s 2 , P < 0.001). pIVA (r) levels predicted the incidence of readmission for worsening HF during follow‐up (HR 0.78, 95% confidence interval 0.64–0.96, P < 0.05), even after multivariable analysis. The assessment of pIVA (r) in addition to left ventricular ejection fraction (LVEF) and E/E′ provided additional prognostic value (Log Rank P < 0.05). The presence of abnormal pIVA (r), LVEF, and E/E′ levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow‐up than those with 2 abnormal marker levels or 0–1 (Log Rank P < 0.05). Conclusions Peak myocardial acceleration during isovolumic relaxation time may represent an independent adjunctive tool for the risk stratification of patients with CHF.