Additional Prognostic Value of EAS index in predicting the occurrence of rehospitalizations in chronic heart failure: data from the Daunia Heart Failure Registry

Michele Correale; Antonio Totaro; Armando Ferraretti; Francesco Musaico; Tommaso Passero; Fiorella De Rosa; Silvia Abruzzese; Riccardo Ieva; Matteo Di Biase; Natale Daniele Brunetti

doi:10.1111/eci.12514

August 8, 2015European Journal of Clinical Investigation

Additional Prognostic Value of EAS index in predicting the occurrence of rehospitalizations in chronic heart failure: data from the Daunia Heart Failure Registry

View Full Paper

Ask AI

Bookmark

Share

Why the study?

Does the EAS index assessed by tissue Doppler imaging predict the risk of rehospitalizations in patients with chronic heart failure?

Structured PICO

Does the EAS index assessed by tissue Doppler imaging predict the risk of rehospitalizations in patients with chronic heart failure?

P

Population

287 consecutive patients with chronic heart failure (CHF) enrolled in the Daunia Heart Failure Registry

I

Intervention

EAS index (combined index of diastolic and systolic performance E'/(A'xS') quantified by Tissue Doppler imaging)

C

Comparator

Lower EAS index values (≤median 0.115) and traditional echocardiographic parameters (LVEF and MPI)

O

Outcome

Rehospitalizations for worsening heart failurehard clinical

The EAS index assessed by tissue Doppler imaging provides independent adjunctive prognostic value for predicting rehospitalization in chronic heart failure patients beyond traditional parameters like LVEF.

Implication

May support rehospitalization risk stratification in chronic HF; leaves open whether prospective use alters management or outcomes.

Abstract

BACKGROUND: Tissue Doppler imaging (TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure (CHF). The clinical role of newly developed TDI parameters, however, still needs to be documented. METHODS: A total of 287 consecutive patients with CHF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and were followed prospectively for a median 255 (204-316) days. Conventional echocardiography and TDI parameters were calculated. We also quantified by TDI a combined index (EAS index) of diastolic and systolic performance E'/(A'xS') and assessed its possible additional prognostic role in combination with 'traditional' parameters such as left ventricular ejection fraction (LVEF) and myocardial performance index (MPI). RESULTS: Subjects readmitted for worsening HF were characterized by higher levels of EAS index (median 0·14 (95% C.I. 0·12-0·21) vs. 0·11 (0·10-0·12, P < 0·05)). Increased rates of rehospitalization were found in subjects with EAS index >median (0·115) (21% vs. 10%, P < 0·05); higher EAS index values predicted the incidence of readmissions for worsening HF during follow-up, even at multivariable analysis. The assessment of EAS index in addition to LVEF and MPI showed an adjunctive prognostic value (log-rank P < 0·001 and P < 0·05, respectively). CONCLUSIONS: EAS index assessed by TDI may be helpful in predicting the risk of rehospitalizations in subjects with CHF. EAS index may represent an independent adjunctive tool for the risk stratification of patients with CHF in addition to 'traditional' tools such as LVEF or MPI.