Left ventricular outflow tract velocity-time integral improves outcome prediction  in patients with secondary mitral regurgitation.

Gentile, Francesco; Buoncristiani, Francesco; Sciarrone, Paolo; Bazan, Lorenzo; Panichella, Giorgia; Gasparini, Simone; Chubuchny, Vlad; Taddei, Claudia; Poggianti, Elisa; Fabiani, Iacopo; Petersen, Christina; Lancellotti, Patrizio; Passino, Claudio; Emdin, Michele; Giannoni, Alberto

doi:10.1016/j.ijcard.2023.131272

Article (Scientific journals)

Left ventricular outflow tract velocity-time integral improves outcome prediction in patients with secondary mitral regurgitation.

Gentile, Francesco; Buoncristiani, Francesco; Sciarrone, Paolo et al.

2023 • In International Journal of Cardiology, p. 131272

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/306253

DOI
10.1016/j.ijcard.2023.131272

PubMed
37604287

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Keywords :

Cardiac output; Ejection fraction; Heart failure; LVOT-VTI; Mitral regurgitation; Stroke volume; Systolic function

Abstract :

[en] AIMS: Left ventricular outflow velocity-time integral (LVOT-VTI) has been shown to improve outcome prediction in different patients' subsets, with or without heart failure (HF). Nevertheless, the prognostic value of LVOT-VTI in patients with HF and secondary mitral regurgitation (MR) has never been investigated so far. Therefore, in the present study, we aimed to assess the prognostic value different metrics of LV forward output, including LVOT-VTI, in HF patients with secondary MR. METHODS AND RESULTS: Consecutive patients with HF and moderate-to-severe/severe secondary MR and systolic dysfunction (i.e., left ventricular ejection fraction [LVEF] <50%) were retrospectively selected and followed-up for the primary endpoint of cardiac death. Out of the 287 patients analyzed (aged 74 ± 11 years, 70% men, 46% ischemic etiology, mean LVEF 30 ± 9%, mean LVOT-VTI 20 ± 5 cm), 71 met the primary endpoint over a 33-month median follow-up (16-47 months). Patients with an LVOT-VTI ≤17 cm (n = 96, 32%) showed the greatest risk of cardiac death (Log Rank 44.3, p < 0.001) and all-cause mortality (Log rank 8.6, p = 0.003). At multivariable regression analysis, all the measures of LV forward volume (namely LVOT-VTI, stroke volume index, cardiac output, and cardiac index) were predictors of poor outcomes. Among these, LVOT-VTI was the most accurate in risk prediction (univariable C-statistics 0.70 [95%CI 0.64-0.77]). CONCLUSION: Left ventricular forward output, noninvasively estimated through LVOT-VTI, improves outcome prediction in HF patients with low LVEF and secondary MR.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Gentile, Francesco; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.

Buoncristiani, Francesco; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

Sciarrone, Paolo; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

Bazan, Lorenzo; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.

Panichella, Giorgia; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.

Gasparini, Simone; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.

Chubuchny, Vlad; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

Taddei, Claudia; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

Poggianti, Elisa; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

Fabiani, Iacopo; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.

More authors (5 more)

Language :

English

Title :

Left ventricular outflow tract velocity-time integral improves outcome prediction in patients with secondary mitral regurgitation.

Publication date :

19 August 2023

Journal title :

International Journal of Cardiology

ISSN :

0167-5273

eISSN :

1874-1754

Publisher :

Elsevier, Nl

Pages :

131272

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 05 September 2023

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