PMID- 12075269
OWN - NLM
STAT- MEDLINE
DCOM- 20020718
LR  - 20190626
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 143
IP  - 6
DP  - 2002 Jun
TI  - Deceleration time of early filling in patients with left ventricular systolic 
      dysfunction: functional and prognostic independent value.
PG  - 1101-6
AB  - BACKGROUND: Although diastolic function parameters have been mentioned as 
      significant predictors of functional capacity and prognosis in patients with left 
      ventricular (LV) systolic dysfunction, it has not been fully elucidated whether 
      they keep an independent predictive value when multiple parameters from a wide 
      variety of examinations are considered. METHODS: We prospectively studied 60 
      patients with New York Heart Association (NYHA) class II-IV chronic heart failure 
      symptoms and LV ejection fraction <0.4. At the time of entry into the study, 
      demographic data and functional class were obtained, and usual Doppler 
      echocardiographic, radionuclide ventriculographic, cardiopulmonary exercise 
      testing and hemodynamic variables were determined. Deceleration time of early 
      filling (DT) and NYHA functional class were the only independent predictors of 
      functional capacity as assessed by means of peak oxygen uptake (peak VO2). Mean 
      follow-up was 21 +/- 6 months, and event-free survival was defined as the absence 
      of cardiac death, urgent cardiac transplantation, or hospital admission requiring 
      inotropic or mechanical support. RESULTS: Multivariate Cox analysis showed that 
      DT (P =.008), peak VO2 (P =.01), and NYHA class (P =.02) were independent 
      predictors of event-free survival at 1 year. Patients in the lowest tertile of DT 
      (<130 ms) had a significantly lower event-free survival than patients in the 
      intermediate (44% vs 80%, P =.03) and in the highest tertile (44% vs 83%, P 
      =.02). Patients with both a DT <130 milliseconds and a peak VO2 <14 mL/kg/min had 
      the highest rate of events at 1 year (83% vs 22% for the remaining patients, 
      relative risk 3.75, P <.001). CONCLUSIONS: In patients with LV systolic 
      dysfunction, DT is a powerful independent predictor of functional capacity and 
      prognosis among a wide variety of variables. A shortened DT (<130 ms) identifies 
      a subgroup of patients with a worse outcome, especially when combined with a 
      reduced peak VO2 (<14 mL/kg/min).
FAU - Morales, Francisco J
AU  - Morales FJ
AD  - Department of Cardiology, Puerto Real University Hospital, Puerto Real, Cadiz, 
      Spain. franjmo@teleline.es
FAU - Asencio, Maria C
AU  - Asencio MC
FAU - Oneto, Jesus
AU  - Oneto J
FAU - Lozano, Javier
AU  - Lozano J
FAU - Otero, Enrique
AU  - Otero E
FAU - Maestre, Manuel
AU  - Maestre M
FAU - Iraavedra, Marisol
AU  - Iraavedra M
FAU - Martinez, Pedro
AU  - Martinez P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - Diastole
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/complications/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oxygen Consumption
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/complications/diagnostic imaging/*physiopathology
EDAT- 2002/06/21 10:00
MHDA- 2002/07/19 10:01
CRDT- 2002/06/21 10:00
PHST- 2002/06/21 10:00 [pubmed]
PHST- 2002/07/19 10:01 [medline]
PHST- 2002/06/21 10:00 [entrez]
AID - S0002870302000297 [pii]
AID - 10.1067/mhj.2002.122119 [doi]
PST - ppublish
SO  - Am Heart J. 2002 Jun;143(6):1101-6. doi: 10.1067/mhj.2002.122119.