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Left ventricular outflow tract velocity time integral in hospitalized heart failure with preserved ejection fraction

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Title: Left ventricular outflow tract velocity time integral in hospitalized heart failure with preserved ejection fraction
Authors: Omote, Kazunori Browse this author
Nagai, Toshiyuki Browse this author →KAKEN DB
Iwano, Hiroyuki Browse this author →KAKEN DB
Tsujinaga, Shingo Browse this author →KAKEN DB
Kamiya, Kiwamu Browse this author →KAKEN DB
Aikawa, Tadao Browse this author →KAKEN DB
Konishi, Takao Browse this author
Sato, Takuma Browse this author
Kato, Yoshiya Browse this author
Komoriyama, Hirokazu Browse this author
Kobayashi, Yuta Browse this author
Yamamoto, Kazuhiro Browse this author
Yoshikawa, Tsutomu Browse this author
Saito, Yoshihiko Browse this author
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: Heart failure with preserved ejection fraction
Left ventricular outflow tract velocity time integral
Prognosis risk stratification
Issue Date: Feb-2020
Publisher: Wiley Periodicals, Inc
Journal Title: ESC heart failure
Volume: 7
Issue: 1
Start Page: 167
End Page: 175
Publisher DOI: 10.1002/ehf2.12541
Abstract: Aims The prognostic implication of left ventricular outflow tract velocity time integral (LVOT-VTI) on admission in hospitalized heart failure with preserved ejection fraction (HFpEF) patients has not been determined. We sought to investigate whether LVOT-VTI on admission is associated with worse clinical outcomes in hospitalized patients with HFpEF. Methods and results We studied consecutive 214 hospitalized HFpEF patients who had accessible LVOT-VTI data on admission, from a prospective HFpEF-specific multicentre registry. The primary outcome of interest was the composite of all-cause death and readmission due to heart failure. During a median follow-up period of 688 (interquartile range 162-810) days, the primary outcome occurred in 83 patients (39%). The optimal cut-off value of LVOT-VTI for the primary outcome estimated by receiver operating characteristic analysis was 15.8 cm. Lower LVOT-VTI was significantly associated with the primary outcome compared with higher LVOT-VTI (P = 0.005). Multivariable Cox regression analyses revealed that lower LVOT-VTI was an independent determinant of the primary outcome (hazard ratio 0.94, 95% confidence interval 0.91-0.98). In multivariable linear regression, haemoglobin level was the strongest independent determinant of LVOT-VTI among clinical parameters (beta coefficient = -0.61, P = 0.007). Furthermore, patients with lower LVOT-VTI and anaemia had the worst clinical outcomes among the groups (P < 0.001). Conclusions Lower admission LVOT-VTI was an independent determinant of worse clinical outcomes in hospitalized HFpEF patients, indicating that LVOT-VTI on admission might be useful for categorizing a low-flow HFpEF phenotype and risk stratification in hospitalized HFpEF patients.
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Type: article
URI: http://hdl.handle.net/2115/77044
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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