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Visual echocardiographic scoring system of the left ventricular filling pressure and outcomes of heart failure with preserved ejection fraction

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Title: Visual echocardiographic scoring system of the left ventricular filling pressure and outcomes of heart failure with preserved ejection fraction
Authors: Murayama, Michito Browse this author
Iwano, Hiroyuki Browse this author →KAKEN DB
Obokata, Masaru Browse this author
Harada, Tomonari Browse this author
Omote, Kazunori Browse this author
Kagami, Kazuki Browse this author
Tsujinaga, Shingo Browse this author
Chiba, Yasuyuki Browse this author
Ishizaka, Suguru Browse this author
Motoi, Ko Browse this author
Tamaki, Yoji Browse this author
Aoyagi, Hiroyuki Browse this author
Nakabachi, Masahiro Browse this author
Nishino, Hisao Browse this author
Yokoyama, Shinobu Browse this author
Tanemura, Asuka Browse this author
Okada, Kazunori Browse this author
Kaga, Sanae Browse this author
Nishida, Mutsumi Browse this author
Nagai, Toshiyuki Browse this author
Kurabayashi, Masahiko Browse this author
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: echocardiography
heart failure with preserved ejection fraction
left ventricular filling pressure
VMT score
Issue Date: May-2022
Publisher: Oxford University Press
Journal Title: European heart journal cardiovascular Imaging
Volume: 23
Issue: 5
Start Page: 616
End Page: 626
Publisher DOI: 10.1093/ehjci/jeab208
Abstract: Aims Elevated left ventricular filling pressure (LVFP) is a powerful indicator of worsening clinical outcomes in heart failure with preserved ejection fraction (HFpEF); however, detection of elevated LVFP is often challenging. This study aimed to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF. Methods and results We retrospectively investigated 310 well-differentiated HFpEF patients in stable conditions. VMT was scored from 0 to 3 using two-dimensional echocardiographic images, and VMT >= 2 was regarded as a sign of elevated LVFP. The primary endpoint was a composite of cardiac death or heart failure hospitalization during the 2 years after the echocardiographic examination. In all patients, Kaplan-Meier curves showed that VMT >= 2 (n = 54) was associated with worse outcomes than the VMT <= 1 group (n = 256) (P < 0.001). Furthermore, VMT >= 2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (AF) (P = 0.026). In the adjusted model, VMT >= 2 was independently associated with the primary outcome (hazard ratio 2.60, 95% confidence interval 1.46-4.61; P = 0.001). Additionally, VMT scoring provided an incremental prognostic value over clinically relevant variables and diastolic function grading (chi(2) 10.8-16.3, P = 0.035). Conclusions In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.
Type: article
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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