Copyright © 2005, The European Society of Cardiology
Value of left ventricular filling parameters to predict mortality and functional class in patients with heart disease from the community
aCardiovascular Department Y, Bispebjerg Hospital, Copenhagen, Denmark
bCardiovascular Department, Hvidovre Hospital, Copenhagen, Denmark
cCardiology Department B, Rigshospitalet, Denmark
Received 11 January 2004; received in revised form 14 July 2004; accepted after revision 23 July 2004.
* Olav Wendelboe Nielsen was supported by a grant from the Danish Heart Foundation.
* Corresponding author. Cardiology Department B, Rigshospitalet, 2200 Copenhagen, Denmark. Tel.: +45 35452141; fax: +45 35452568. own{at}dadlnet.dk
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Abstract |
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Surprisingly few studies described the value of Doppler parameters in patients from the community.
Aim The aim was to determine the prevalence of prolonged IVRT (>0.105s) or a prolonged EDT (>0.280s) with a reduced E/A (<0.5) in heart patients from the community without valvular, systolic or rhythmic dysfunction. The associations of these parameters to all cause mortality and NYHA functional class were examined as well.
Methods Seventy-two volunteer stable patients with a history of heart disease were identified from general practice. Patients with LVEF below 0.45, valvular abnormalities, atrial fibrillation, and pacemaker were excluded. Routine blood tests, echocardiography, chest X-ray, physical examination and mortality were evaluated.
Results Patient findings: male 33%, mean age of 68 years, hypertension 82%, ischaemic heart disease 43%, and NYHA class I+II+III in 50+39+11%. Abnormal EDT occurred in 4% (95% CI from 0 to 9%), IVRT in 18% (9–27%), E/A in 0%. None had a restrictive pattern. EDT was longer in NYHA III than in NYHA I–II patients (median 0.25 vs. 0.19s, p=0.0006). E/A and IVRT were not associated with NYHA class or mortality. After 7.4 years 16 of 72 patients died. EDT predicted mortality in univariate analysis but not in a multivariate analysis where NYHA class and gender were the only significant predictors.
Conclusion Prolonged EDT was weakly associated to NYHA class and mortality while IVRT and E/A were not. Prolonged IVRT was a frequent finding, but a diagnosis of diastolic dysfunction is not supported by mild to moderate abnormal IVRT or E/A.
Keywords: Doppler ultrasound; Mortality; Prevalence; Diagnosis; Diastolic function
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