Left Ventricular Outflow Tract and Pulmonary Artery Stroke Distances Independently Predict Heart Failure Hospitalization and Mortality: The Heart and Soul Study - 10/08/11
, Beeya Na, MPH b, Sadia Ali, MD, MPH b, Mary A. Whooley, MD b, Nelson B. Schiller, MD c
Reprint requests: Bryan Ristow, MD, Associate Professor of Medicine, MercerUniversity, Savannah Campus, 455 S Main St, Suite 205.Abstract |
Background |
Stroke distance of the left ventricular outflow tract (LVOT) or pulmonary artery (PA) is readily measurable by Doppler echocardiography. Stroke distance, calculated by the velocity time integral, expresses the average linear distance traveled by red blood cells during systole. We hypothesized that reduced stroke distance predicts heart failure (HF) hospitalization or mortality among ambulatory adults with stable coronary artery disease.
Methods |
We compared stroke distances by lowest quartile among 990 participants in the Heart and Soul Study. We calculated hazard ratios (HRs) for events adjusted for clinical and echocardiographic parameters.
Results |
At 5.9 ± 1.9-year follow-up, there were 154 HF hospitalizations and 271 all-cause deaths. Among 254 participants with LVOT stroke distance in the lowest quartile (≤18 cm), 24% developed HF hospitalization, compared with 10% of those with higher stroke distance (HR 2.7; CI, 2.0–3.8; P < .0001). This association remained after adjustment for multiple variables including medical history, heart rate, blood pressure, and left ventricular ejection fraction (HR 1.8; CI, 1.1–3.0; P = .02). Both LVOT stroke distance ≤18 cm and PA stroke distance ≤17 cm were independently associated with the combined end point of HF hospitalization and mortality (HR 1.4; CI, 1.1-1.9; P = .02).
Conclusion |
Reduced stroke distance predicts HF hospitalization and mortality independent of clinical and other echocardiographic parameters among ambulatory adults with coronary artery disease.
Le texte complet de cet article est disponible en PDF.Keywords : Doppler echocardiography, Heart failure, Stroke distance, Velocity time integral
Abbreviations : HF, HR, LVEF, LVOT, PA
Plan
| This study was supported by the Department of Veterans Affairs (Epidemiology Merit Review Program), the Robert Wood Johnson Foundation (Generalist Physician Faculty Scholars Program), the American Foundation for Aging Research (Paul Beeson Faculty Scholars in Aging Research Program), the Nancy Kirwan Heart Research Fund, and an equipment loan from Siemens Corporation (Mountain View, CA). |
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| Conflicts of Interest: None. |
Vol 24 - N° 5
P. 565-572 - mai 2011 Retour au numéro
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