Prognostic value of Doppler transmitral filling patterns in patients with chronic heart failure  

作　　者：郑哲岚 A.Meissner B.Hausmann H.Alexander R.Simon 

机构地区：[1]Department of Ultrasonography, First Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou 310003, China [2]Department of Cardiology, Kiel University Hospital, Germany

出　　处：《Chinese Medical Journal》2004年第2期176-182,共7页中华医学杂志（英文版）

摘　　要：Background Chronic heart failure is a significant cause of cardiovascular morbidity and mortality. This study tested the hypothesis that restrictive filling pattern may provide useful prognostic data for identifying patients with chronic heart failure at high risk of all-cause cardiac death.Methods Ninety patients with chronic heart failure [ 70 men and 20 women, mean age (58.1 ± 11.6) years] were investigated and followed for (18. 8 ±7. 9) months. During this period, 14 patients died of progressive pump failure, 12 patients underwent heart transplantation, 5 patients died suddenly, and 2 patients died of acute myocardial infarction. A new criterion, the restrictive filling index (RFI), was designed to subgroup patients into a restrictive and a nonrestrictive group.Results Patients with restrictive filling pattern had a more severe left ventricular dysfunction and a higher cardiac mortality. Analysis by the Kaplan-Meier method revealed that patients in the RFI≥1 and RFI <1 groups had a cardiac events-free survival rate of 52% versus 94% at 1 year, and 27. 5% versus 92% at 2 years, respectively. The multivariate Cox proportional hazard model selected RFI as the most powerful prognostic factor (x2 =8. 8017, P=0. 0030) for all-cause cardiac death.Conclusion These results indicate that RFI is a simple, noninvasive, and specific clinical predictor for adult chronic heart failure patients who are at a high risk for all-cause cardiac death.Background Chronic heart failure is a significant cause of cardiovascular morbidity and mortality. This study tested the hypothesis that restrictive filling pattern may provide useful prognostic data for identifying patients with chronic heart failure at high risk of all-cause cardiac death.Methods Ninety patients with chronic heart failure [ 70 men and 20 women, mean age (58.1 ± 11.6) years] were investigated and followed for (18. 8 ±7. 9) months. During this period, 14 patients died of progressive pump failure, 12 patients underwent heart transplantation, 5 patients died suddenly, and 2 patients died of acute myocardial infarction. A new criterion, the restrictive filling index (RFI), was designed to subgroup patients into a restrictive and a nonrestrictive group.Results Patients with restrictive filling pattern had a more severe left ventricular dysfunction and a higher cardiac mortality. Analysis by the Kaplan-Meier method revealed that patients in the RFI≥1 and RFI <1 groups had a cardiac events-free survival rate of 52% versus 94% at 1 year, and 27. 5% versus 92% at 2 years, respectively. The multivariate Cox proportional hazard model selected RFI as the most powerful prognostic factor (x2 =8. 8017, P=0. 0030) for all-cause cardiac death.Conclusion These results indicate that RFI is a simple, noninvasive, and specific clinical predictor for adult chronic heart failure patients who are at a high risk for all-cause cardiac death.

关 键 词：PROGNOSIS ECHOCARDIOGRAPHY DOPPLER heart failure CONGESTIVE blood flow velocity 

分 类 号：R541.6[医药卫生—心血管疾病]