Relation Between Echocardiogram-Based Cardiac Parameters and Outcome in Heart Failure With Preserved and Reduced Ejection Fraction
Obokata, M and Takeuchi, M and Negishi, K and Ohte, N and Izumo, M and Yamashita, E and Ebato, M and Yuda, S and Kurabayashi, M and Nakatani, S, Relation Between Echocardiogram-Based Cardiac Parameters and Outcome in Heart Failure With Preserved and Reduced Ejection Fraction, American Journal of Cardiology, 118, (9) pp. 1356-1362. ISSN 0002-9149 (2016) [Refereed Article]
The purposes of this study were to investigate whether heart failure (HF) with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) share echocardiographic predictors and elucidate E/(e' × s') that predicts major adverse cardiovascular events (MACE) independent of other echocardiographic parameters in each HF group. We assessed tissue Doppler-derived parameters [E/e', E/(e' × s')] and left ventricular and right ventricular longitudinal strains in HFrEF (n = 340) and HFpEF (n = 102). Left ventricular and right ventricular longitudinal strains were significantly higher and E/(e' × s') was lower in patients with HFpEF compared with those with HFrEF, whereas E/e' was similar between the groups. During a median follow-up of 342 days, MACE developed in 95 patients with HFrEF and 29 with HFpEF. The univariable analysis revealed similar echocardiographic predictors between the 2 groups, including E/e', E/(e' × s') and pulmonary artery systolic pressure. No 2-dimensional speckle tracking-derived parameter remained significant in multivariable models in each HF group. E/(e' × s') was an only independent predictor with an incremental prognostic value over the Meta-analysis Global Group in Chronic Heart Failure score and was superior to the E/e' ratio in both HFrEF and HFpEF. In conclusion, despite differences in echocardiography-based cardiac function parameters between HFrEF and HFpEF, these HF phenotypes shared the same echocardiographic predictors of future MACE. E/(e' × s') was an only independent predictor for future cardiac events in both HF populations.