Abstract 15943: Left Ventricular Regional Longitudinal Displacement Assessed by Tissue Doppler Imaging is a Powerful Predictor of All-cause Mortality in Patients With Systolic Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Morten Sengeløv ◽  
Peter Godsk Jørgensen ◽  
Niels Eske Bruun ◽  
Flemming Javier Olsen ◽  
Thomas Fritz Hansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Longitudinal Displacement ◽  
Predictors Of Mortality ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Objective: Tissue tracking (TT), obtained by tissue Doppler imaging (TDI), can be utilized to assess the mitral annular longitudinal displacement (LD) during systole. However, the prognostic utility of regional LD in patients with heart failure with reduced ejection fraction (HFrEF) is unknown. Methods: Transthoracic echocardiographic examinations from 911 patients with HFrEF were retrieved from a heart failure clinic’s database. The exams were performed from 2005 to 2013. The echocardiographic images were subsequently analyzed obtaining conventional echocardiographic measurements. Regional LD was obtained from the three apical TDI projections with sampling at six mitral annular sites located at the anterior, lateral, posterior, inferior, septal and anteroseptal myocardial walls. Results: During a median follow-up period of 40 months 150 (16.4 %) patients died. Patients that died had significantly lower LVEF (23.3% vs 28.3%, p<0.001) and lower regional LD in all six mitral annular sites (Figure). Many conventional echocardiographic parameters presented as predictors of mortality (LVEF, LVMI, LAVI, E, E/e’, deceleration time and TAPSE). However, only LD at the septal and inferior annular sites remained independent predictors of mortality in cox proportional-hazards models after adjusting for age, gender, BMI, total cholesterol, heart rate, atrial fibrillation, non-independent diabetes mellitus and the aforementioned conventional echocardiographic predictors (Figure). In addition, the septal and the inferior sites had the highest Harrell’s C-statistic of all the echocardiographic predictors (0.70 and 72, respectively). Conclusion: In patients with severe heart failure, septal and inferior LD are independent predictors of all-cause mortality. Furthermore, septal and inferior LD proved to be superior prognosticators when compared to all the conventional echocardiographic parameters.

scholarly journals Tissue doppler imaging for estimation of left ventricular filling pressure in patients with systolic and diastolic heart failure: a comparative simultaneous doppler catheterization study

2020 ◽  
Vol 7 (2) ◽  
pp. 319
Author(s):  
Manohar J. Suranagi ◽  
K. Subramanyam ◽  
K. S. Subramani ◽  
K. H. Srinivasa
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Diastolic Heart Failure ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Doppler Imaging ◽  
Heart Failure Patients ◽  
Mitral Annular Velocity

Background: Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether the lateral mitral annular velocity as assessed by tissue Doppler imaging is associated with invasive measures of diastolic LV performance in patients with diastolic and systolic heart failure. Aim of the study was to compare the diagnostic accuracy of lateral mitral annular E/E′ as an estimate of LV filling pressure with invasive LVEDP measurement in subjects with systolic or purely diastolic heart failure.Methods: Total 100 patients were studied, 50 patients with diastolic heart failure and 50 patients with systolic heart failure in patients undergoing diagnostic coronary angiogram. Detailed 2D Echocardiography, Trans mitral Doppler and Tissue Doppler velocities of lateral mitral annulus was obtained. The ratio of peak mitral velocity (E) to lateral mitral annular velocity (E′) by TDI (E/E′) was calculated.Results: The ratio of E/E′ in diastolic group was 13.4±4.9 and in systolic group it was 13.7±5.2. The mean LVEDP in diastolic heart failure patients was 14.3±4.5 and 14.2±4.9 in systolic heart failure patients. The ratio of E/E′ showed a better correlation with LVEDP. E/E′ <8 accurately predicted normal LVEDP, and E/E′ >15 identified increased LVEDP ≥15mmHg.Conclusions: E/E′ is a reliable estimate of LV filling pressures in subjects with systolic and diastolic heart failure. In subjects with diastolic heart failure, E/E′ seems helpful to identify those with truly elevated LV filling pressures. In patients with diastolic heart failure and normal E/E′, a search for other causes of symptoms (pulmonary disease, obesity and so forth) may be warranted.

scholarly journals Dyssynchrony Assessment with Tissue Doppler Imaging and Regional Volumetric Analysis by 3D Echocardiography Do Not Predict Long-Term Response to Cardiac Resynchronization Therapy

2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
Suman S. Kuppahally ◽  
Michael B. Fowler ◽  
Randall Vagelos ◽  
Paul Wang ◽  
Amin Al-Ahmad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Tissue Doppler Imaging ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Volumetric Analysis ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy

Background. Currently there are no reliable predictors of response to cardiac resynchronization therapy (CRT) before implantation. We compared pre-CRT left ventricular (LV) dyssynchrony by tissue Doppler imaging (TDI) and regional volumetric analysis by 3-dimensional transthoracic echocardiography (3DTTE) in predicting response to CRT.Methods. Thirty-eight patients (79% nonischemic cardiomyopathy) with symptomatic heart failure who underwent CRT were enrolled. Clinical and echocardiographic responses were defined as improvement in one NYHA class and reduction in LV end-systolic volume by ≥15% respectively. Functional status was assessed by Minnesota Living with Heart Failure questionnaire and 6-minute walk distance.Results. In 33 patients, after CRT for 7.86 ± 2.27 months, there were 24 (73%) clinical and 19 (58%) echocardiographic responders. Functional parameters, LV dimensions, volumes and synchrony by TDI and 3DTTE improved significantly in responders. There was no difference in the number of responders and nonresponders when cut-off values for dyssynchrony by different measurements validated in other trials were applied. Area under receiver-operating-characteristic curve ranged from 0.4 to 0.6.Conclusion. CRT improves clinical and echocardiographic parameters in patients with systolic heart failure. The dyssynchrony measurements by TDI and 3DTTE are not comparable and are unable to predict response to CRT.

scholarly journals Correlation of QRS duration with intraventricular mechanical dyssynchrony on tissue Doppler imaging in heart failure

2018 ◽  
Vol 5 (2) ◽  
pp. 46-51
Author(s):  
Sanjaya Kumar Shrestha
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Tissue Doppler ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cardiac Resynchronization ◽  
Time To Peak ◽  
Significant Difference ◽  
Qrs Duration

Introductions: Wide QRS complex with left bundle branch block morphology is one of the three criteria for cardiac resynchronization therapy (CRT) in heart failure (HF) patients who do not improve on medical management. Approximately 30% of patients do not respond to CRT. This study investigates to find out to what extent the wide QRS duration correlates with the intraventricular mechanical dyssynchrony (IVMD) as measured by Tissue Doppler Imaging (TDI) echocardiography. Methods: The HF patients of dilated or ischemic cardiomyopathy with ejection fraction £35% admitted in the medical ward of Patan Hospital, Nepal from March to August 2017 were enrolled in the study. They were divided into two groups, narrow QRS duration of <120ms (Gr1) and wide QRS duration of ³120ms (Gr2). TDI was performed to measure time to peak systolic velocity of the left ventricular walls. The IVMD, defined as 60 ms (millisecond) or greater difference in time to peak velocity between any two points of the left ventricular walls, was compared in both groups. Results: There were 26 patients, 18 in group-1, and eight in Gr2.In Gr1, IVMD was observed 13/18 (72%) patients and in group-2 in 7/8 (87%) patients, (χ2 = 0.70, p = 0.403). There was no significant difference of IVMD between Gr1 and Gr2 (73±36ms vs 97±38ms, t = 1.54, p = 0.136).   Conclusions: Assessment of intraventricular mechanical dyssynchrony (IVMD) by Tissue Doppler Imaging (TDI) is probably superior to QRS duration in heart failure patients.

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