Key result
A 10 ms decrease in systolic ejection time is linked to ~6% higher mortality in HFrEF.
Why the study?
Whether cardiac time intervals obtained by the colour tissue Doppler imaging M-mode method can predict outcome in patients with heart failure with reduced ejection fraction remains unknown.
Does left ventricular systolic ejection time (SET) measured by tissue Doppler imaging predict all-cause mortality in patients with HFrEF?
Cohort (n=997)
Does left ventricular systolic ejection time (SET) measured by tissue Doppler imaging predict all-cause mortality in patients with HFrEF?
Answers are grounded in this paper and cite their sources.
Shorter left ventricular systolic ejection time measured by tissue Doppler imaging is an independent predictor of all-cause mortality in patients with HFrEF.
AIMS: Colour tissue Doppler imaging (TDI) M-mode through the mitral leaflet is an easy and precise method to obtain cardiac time intervals including isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and systolic ejection time (SET). The myocardial performance index (MPI) is defined as [(IVCT + IVRT)/SET]. Whether cardiac time intervals obtained by the TDI M-mode method can be used to predict outcome in patients with heart failure with reduced ejection fraction (HFrEF) remains unknown. METHODS AND RESULTS: A total of 997 patients with HFrEF (mean age 67 ± 11 years, 74% male) underwent an echocardiographic examination including TDI. During a median follow-up of 3.4 years (interquartile range 1.9-4.8 years), 165 (17%) patients died. The risk of mortality increased by 9% per 10 ms decrease in SET [per 10 ms decrease: hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.06-1.13; P < 0.001]. The association remained significant even after multivariable adjustment for clinical and echocardiographic parameters (per 10 ms decrease: HR 1.06, 95% CI 1.01-1.11; P = 0.030). The MPI was a significant predictor in an unadjusted model (per 0.1 increase: HR 3.06, 95% CI 1.16-8.06; P = 0.023). However, the association did not remain significant after multivariable adjustment. No significant associations between IVCT or IVRT and mortality were found in unadjusted nor adjusted models. Additionally, SET provided incremental prognostic information with regard to predicting mortality when added to established clinical predictors of mortality in patients with HFrEF. CONCLUSION: In patients with HFrEF, SET provides independent and incremental prognostic information regarding all-cause mortality.
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Alhakak et al. (2020) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=997). Systolic ejection time (SET) measurement was evaluated on All-cause mortality (HR 1.06, 95% CI 1.01-1.11, p=0.030). In patients with HFrEF, a 10 ms decrease in systolic ejection time was independently associated with an increased risk of all-cause mortality.
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