Left ventricular outflow tract velocity time integral (LVOT VTI) was an independent predictor of mortality in patients with LV dysfunction (adjusted OR 0.959; 95% CI 0.923-0.997; p=0.034).
Cohort (n=30,391)
Yes
Does LVOT VTI predict mortality in patients with left ventricular dysfunction?
LVOT VTI is an independent predictor of mortality in patients with left ventricular dysfunction, highlighting its potential utility for risk stratification and early management.
Effect estimate: OR 0.959 (95% CI 0.923-0.997)
p-value: p=0.034
Abstract Background LVOT VTI , a surrogate marker of cardiac output, may predict mortality in patients with left ventricular (LV) dysfunction. Method Patients with LV ejection fraction (LVEF) 50% in NEDA between October 2003 and May 2019 were included. Mortality was assessed, with a median follow-up of 58 months (IQR: 35-94). Multivariate logistic regression was used to evaluate the predictive value of LVOT VTI. Results In 30 391 patients with LVEF 50% (mean age 68.5 + 15.6 years; 70% male), there were 13 611 (45%) deaths. Patients who died were older (74.9 + 12.6 vs 63.2 + 15.8 years, p.001) and less likely to be in sinus rhythm (47% vs 60%, p.001). Adverse features included larger left atria (53.5 + 21.8ml/m2 vs 44.1 + 19.2ml/m2, p.001), raised E/e’ (18.5 + 9.0 vs 13.4 + 6.4, p.001), tricuspid regurgitation (TR) peak gradient (34.9 + 12.6 vs 28.2 + 10.4mmHg, p.001), reduced LVEF (35.0 + 10.1 vs 39.0 + 8.8%, p.001), and LVOT VTI (15.9 + 5.0 vs 17.2 + 4.6cm, p.001). Unadjusted models identified age, sex, LVEF, E/e’, LVOT VTI, and TR peak gradient as predictors of mortality. Multivariate model adjusted for the above and clinical variables of atrial fibrillation and systolic blood pressure confirmed reduced LVEF (adjusted OR .963, 95% CI .946-.982, p=.001) and LVOT VTI (AOR .959, 95% CI .923-.997, p=.034) as independent predictors of mortality. Conclusion LVOT VTI is an independent predictor of mortality in LV dysfunction. Prospective monitoring may improve identification and early management of high-risk patients.
Eng-Frost et al. (Sat,) conducted a cohort in Left ventricular dysfunction (n=30,391). Left ventricular outflow tract velocity time integral (LVOT VTI) was evaluated on Mortality (OR 0.959, 95% CI 0.923-0.997, p=0.034). Left ventricular outflow tract velocity time integral (LVOT VTI) was an independent predictor of mortality in patients with LV dysfunction (adjusted OR 0.959; 95% CI 0.923-0.997; p=0.034).