Pulmonary Venous Flow as Assessed by Transesophageal Echocardiography Independently Predicts Mortality in Patients With Dilated Cardiomyopathy. A Thirteen Year Follow-Up Study

Caiati, Carlo; Lepera, Mario Erminio; Santoro, Daniela; Santis, Alessandro De; Piscopo, A; Rizzo, Caterina; Santis, Delia De; Lagioia, Rocco

doi:10.1016/s0735-1097(12)61128-0

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“…This study did not specifically address the prognostic impact of these parameters. However, S Fract and creatinine clearance have also been shown to have a major independent prognostic implication in a 13-year follow-up, as previously reported [63]. Further prognostic studies are needed in this regard.…”

Section: Study Limitationssupporting

confidence: 61%

Predictors of Exercise Capacity in Dilated Cardiomyopathy with Focus on Pulmonary Venous Flow Recorded with Transesophageal Eco-Doppler

Caiati

Argentiero

Forleo

et al. 2021

JCM

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The aim of this study was to clarify the relative contribution of elevated left ventricle (LV) filling pressure (FP) estimated by pulmonary venous (PV) and mitral flow, transesophageal Doppler recording (TEE), and other extracardiac factors like obesity and renal insufficiency (KI) to exercise capacity (ExC) evaluated by cardiopulmonary exercise testing (CPX) in patients with dilated cardiomyopathy (DCM). During the CPX test, 119 patients (pts) with DCM underwent both peak VO2 consumption and then TEE with color-guided pulsed-wave Doppler recording of PVF and transmitral flow. In 78 patients (65%), peak VO2 was normal or mildly reduced (>14 mL/kg/min) (group 1) while it was markedly reduced (≤14 mL/kg/min) in 41 (group 2). In univariate analysis, systolic fraction (S Fract), a predictor of elevated pre-a LV diastolic FP, appeared to be the best diastolic parameter predicting a significantly reduced peak VO2. Logistic regression analysis identified five parameters yielding a unique, statistically significant contribution in predicting reduced ExC: creatinine clearance < 52 mL/min (odds ratio (OR) = 7.4, p = 0.007); female gender (OR = 7.1, p = 0.004); BMI > 28 (OR = 5.8, p = 0.029), age > 62 years (OR = 5.5, p = 0.03), S Fract < 59% (OR = 4.9, p = 0.02). Conclusion: KI was the strongest predictor of reduced ExC. The other modifiable factors were obesity and severe LV diastolic dysfunction expressed by blunted systolic venous flow. Contrarily, LV ejection fraction was not predictive, confirming other previous studies. This has important clinical implications.

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Section: Study Limitationssupporting

confidence: 61%