Prognostic Value of Echocardiography in 190 Patients with Chronic Congestive Heart Failure

Madsen, Bo; Videbœk, Regitze; Stokholm, Heine; Mortensen, Leif Spange; Hansen, Jørgen Fischer

doi:10.1159/000177096

Cited by 23 publications

(7 citation statements)

References 16 publications

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“…LVEF however, reflects global function and hypercontractile segments may offset hypokinetic segments thereby preserving overall LV systolic function. Some studies have reported that resting WMA is a more powerful predictor of outcome [17] whereas others report incremental prognostic information using both resting WMA and LVEF [18]. In our study, 53% with a resting WMA had an EF ≤ 50%, whereas 2% of patients with no resting WMA had an EF ≤ 50%.…”

Section: Discussioncontrasting

confidence: 44%

“…Regional left ventricular function provides additional prognostic information in patients post myocardial infarction [17, 23], and in patients with heart failure [18]. Although the presence of a resting WMA generally represents prior infarction, stunned or hibernating myocardium, it may also be found in individuals without coronary artery disease [13].…”

Section: Discussionmentioning

confidence: 99%

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The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia

et al. 2013

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BackgroundOur aim was to determine whether regional left ventricular (LV) function on a resting transthoracic echo (TTE) provides prognostic information in patients with varying degrees of ischemia on myocardial perfusion imaging.MethodsBetween 2004 - 2009, we identified 503 patients (mean age 69 (SD 11); 79% male) with reversible ischemia on a myocardial SPECT scan who had a TTE within 30 days. We evaluated the rate of subsequent revascularization and death for all patients.ResultsFollowing the SPECT scan and TTE, 246/503(49%) patients underwent revascularization, 64/503 (13%) patients died, 369 (73%) patients had a normal left ventricular ejection fraction (LVEF), 242 (48%) patients had a resting wall motion abnormality (WMA), 21/261 (8%) with no WMA died compared to 43/242 (18%) in patients with a WMA. In patients with a WMA (n = 242) there was no significant difference in mortality when comparing patients with small (< 6 segments) and large (> 6 segments) WMA (P = 0.44). In patients with moderate/severe ischemia, the presence of a resting WMA was associated with a higher mortality rate (18% v 7%; P = 0.005). In a multivariable model, LVEF (< 50%) was associated with a hazard ratio of 2.2 (P = 0.002, 95% CI 1.34 - 3.68) however, WMA and number of abnormal segments did not reach statistical significance.ConclusionA resting wall motion abnormality in patients with moderate/severe ischemia is associated with a higher mortality compared to patients with mild ischemia on myocardial perfusion imaging. Regional left ventricular dysfunction unlike LVEF was not an independent predictor of mortality.

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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia

et al. 2013

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“…Endeavors to elucidate the disease processes that precede global ventricular dysfunction and its clinical implications have been undertaken mainly in patients with ischemic heart disease (34–36) and heart failure (37). Among these selected symptomatic individuals, regional wall motion abnormalities identified by echocardiography have been shown to predict death and heart failure hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Regional Left Ventricular Myocardial Dysfunction as a Predictor of Incident Cardiovascular Events

Yan

Bluemke

Gomes

et al. 2011

Journal of the American College of Cardiology

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Objectives We sought to examine the prognostic value of subclinical left ventricular (LV) regional myocardial dysfunction (RMD) measured by magnetic resonance imaging (MRI) among asymptomatic individuals. Background LV RMD, defined as segmental impairment in systolic wall thickening, predicts adverse events in patients with established cardiovascular disease. MRI is highly accurate for detecting subtle RMD, of which the prognostic significance in a large multiethnic asymptomatic population is not known. Methods We used MRI to evaluate baseline regional LV myocardial function and prospectively followed a multiethnic (African American, Caucasian, Chinese, and Hispanic) population-based sample of 4,510 men and women without cardiovascular disease for a mean of 4.6 years. Regional myocardial dysfunction was defined as the presence of impaired systolic wall thickening (<10th percentile of segment-specific population distribution) in ≥2 contiguous LV segments within any given coronary artery territory. Results Baseline prevalence of RMD was 25.6%. Heart failure developed in 34 (1.0%) and 30 (2.6%) participants without and with RMD, respectively (p < 0.001). After adjustment for demographics and traditional risk factors, RMD remained independently associated with incident heart failure (hazard ratio [HR]: 2.62; 95% confidence interval [CI]: 1.56 to 4.39; p < 0.001). The relationship persisted after further adjustment for biomarkers of reported association with cardiovascular disease and indexes of global LV systolic dysfunction and hypertrophy (HR: 1.80; 95% CI: 1.02 to 3.20; p = 0.044). Similarly, RMD independently conferred an increased risk for hard coronary events (myocardial infarction or death from coronary heart disease; HR: 1.75; 95% CI: 1.06 to 2.89; p = 0.029), the composite of hard coronary events and stroke (HR: 1.72; 95% CI: 1.16 to 2.56; p = 0.005), and all atherosclerotic cardiovascular events (HR: 1.50; 95% CI: 1.09 to 2.07; p = 0.012). Conclusions Among an asymptomatic multiethnic American cohort, RMD is an independent predictor beyond traditional risk factors and global LV assessment for incident heart failure and atherosclerotic cardiovascular events. The clinical utility of early recognition of this subclinical phenotype deserves further investigation.

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“…It is well known that the LV global functional parameter LVEF is an important predictor of cardiac death in patients with DCM ( 2 , 17 ). The global and regional functions are closely related and the correlation between global systolic wall motion score measured by echocardiography (echocardiographic wall motion score index, WSMI) and LVEF obtained by radionuclide ventriculography is high ( r = 0.72) ( 40 , 41 ). Our present study showed a higher correlation between LVEF and SMS ( r = 0.917), possibly because both of the two parameters were obtained through gated SPECT MPI and were consistent.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of summed motion score assessed by gated SPECT myocardial perfusion imaging in patients with dilated cardiomyopathy

Zhu

Wang

Huang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe prognosis of patients with dilated cardiomyopathy (DCM) is poor and new indicators are urgently needed to predict lethal cardiac events. This study aimed to investigate the value of summed motion score (SMS) in predicting cardiac death of DCM patients using gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).Methods and resultsEighty-one patients with DCM who underwent 99mTc-MIBI gated SPECT MPI were retrospectively enrolled and were divided into cardiac death and survivor groups. The functional parameters of left ventricle including SMS were measured using quantitative gated SPECT software. During the follow-up period of 44 (25, 54) months, 14 (17.28%) cardiac deaths were observed. Compared with the survivor group, SMS was significantly higher in the cardiac death group. Multivariate cox regression analysis showed that SMS was an independent predictor for cardiac death (HR 1.34, 95% CI 1.02–1.77, P = 0.034). SMS also provided incremental prognostic value over other variables in the multivariate model as determined by likelihood ratio global chi-squared test. In the Kaplan-Meier survival analysis, the event-free survival rate was significantly lower in the high-SMS (HSMS) group than the low-SMS (LSMS) (log-rank P < 0.001). Furthermore, the area under curve (AUC) of SMS was larger than that of LVEF at the 12th month of follow-up (0.85 vs. 0.80, P = 0.045).ConclusionSMS is an independent predictor of cardiac death in DCM patients and provides incremental prognostic value. SMS might have higher predictive value than LVEF for early cardiac death.

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Prognostic Value of Echocardiography in 190 Patients with Chronic Congestive Heart Failure

Cited by 23 publications

References 16 publications

The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia

The Prognostic Significance of Resting Regional Left Ventricular Function in Patients With Varying Degrees of Myocardial Ischemia

Regional Left Ventricular Myocardial Dysfunction as a Predictor of Incident Cardiovascular Events

Prognostic value of summed motion score assessed by gated SPECT myocardial perfusion imaging in patients with dilated cardiomyopathy

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