Usefulness of exercise tissue doppler echocardiography for prognostic stratification of congestive heart failure patients with left ventricular systolic dysfunction

AIM: Determination of the importance of exercise tissue Doppler echocardiography in prognostic stratification of congestive heart failure patients with systolic dysfunction. METHODS: 106 patients with congestive heart failure and LVEF ≤ 45% on optimal pharmacotherapy were included in the study. Results of resting and post-exercise echocardiography, cardiopulmonary exercise test and serum BNP levels were available for all patients. Two patient groups were constituted, based on the prognostic classification. Group I contained 21 patients with poor prognosis (defined by predicted value of pVO2 32.7 and BNP > 210 pg/mL) and group II with 85 patients who did not meet the criteria. RESULTS: The patient groups significantly differed in indexed volume of left atrium, mitral regurgitation severity, rest and post-exercise systolic velocity of mitral annulus and in rest and post-exercise E/Em. Multivariate analysis identified E/Em as the only independent predictor of prognosis. E/Em at rest (post-exercise) ≥ 16.6 (≥ 18.7) defined poor prognosis with sensitivity of 71% (86%) and specificity of 71% (71%). CONCLUSION: Our study suggests usefulness of exercise tissue Doppler echocardiography for prognostic stratification of patients with congestive heart failure with possible superiority to resting parameters.