Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial

Research output: Contribution to journalArticle

Kyung Hee Kim, Lilin She, Kerry L. Lee, Rafal Dabrowski, Paul A. Grayburn, Miroslaw Rajda, David L. Prior, Patrice Desvigne-Nickens, William A. Zoghbi, Michele Senni, Guglielmo Stefanelli, Cesare Beghi, Thao Huynh, Eric J. Velazquez, Jae K. Oh, Grace Lin

Aims: We sought to determine which echocardiographic markers of left ventricular (LV) remodeling and diastolic dysfunction can contribute as incremental and independent prognostic information in addition to current clinical risk markers of ischemic LV systolic dysfunction in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Methods and results: The cohort consisted of 1511 of 2136 patients in STICH for whom baseline transmitral Doppler (E/A ratio) could be measured by an echocardiographic core laboratory blinded to treatment and outcomes, and prognostic value of echocardiographic variables was determined by a Cox regression model. E/A ratio was the most significant predictor of mortality amongst diastolic variables with lowest mortality for E/A closest 0.8, although mortality was consistently low for E/A 0.6 to 1.0. Mortality increased for E/A < 0.6 and > 1.0 up to approximately 2.3, beyond which there was no further increase in risk. Larger LV end-systolic volume index (LVESVI) and E/A < 0.6 and > 1.0 had incremental negative effects on mortality when added to a clinical multivariable model, where creatinine, LVESVI, age, and E/A ratio accounted for 74% of the prognostic information for predicting risk. LVESVI and E/A ratio were stronger predictors of prognosis than New York Heart Association functional class, anemia, diabetes, history of atrial fibrillation, and stroke. Conclusions: Echocardiographic markers of advanced LV remodeling and diastolic dysfunction added incremental prognostic value to current clinical risk markers. LVESVI and E/A ratio outperformed other markers and should be considered as standard in assessing risks in ischemic heart failure. E/A closest to 0.8 was the most optimal filling pattern.

Original languageEnglish (US)
Article number17
JournalCardiovascular Ultrasound
Volume18
Issue number1
DOIs
StatePublished - May 28 2020

PMID: 32466790

Altmetrics

Cite this

Standard

Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial. / Kim, Kyung Hee; She, Lilin; Lee, Kerry L.; Dabrowski, Rafal; Grayburn, Paul A.; Rajda, Miroslaw; Prior, David L.; Desvigne-Nickens, Patrice; Zoghbi, William A.; Senni, Michele; Stefanelli, Guglielmo; Beghi, Cesare; Huynh, Thao; Velazquez, Eric J.; Oh, Jae K.; Lin, Grace.

In: Cardiovascular Ultrasound, Vol. 18, No. 1, 17, 28.05.2020.

Research output: Contribution to journalArticle

Harvard

Kim, KH, She, L, Lee, KL, Dabrowski, R, Grayburn, PA, Rajda, M, Prior, DL, Desvigne-Nickens, P, Zoghbi, WA, Senni, M, Stefanelli, G, Beghi, C, Huynh, T, Velazquez, EJ, Oh, JK & Lin, G 2020, 'Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial' Cardiovascular Ultrasound, vol. 18, no. 1, 17. https://doi.org/10.1186/s12947-020-00195-1

APA

Kim, K. H., She, L., Lee, K. L., Dabrowski, R., Grayburn, P. A., Rajda, M., ... Lin, G. (2020). Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial. Cardiovascular Ultrasound, 18(1), [17]. https://doi.org/10.1186/s12947-020-00195-1

Vancouver

Kim KH, She L, Lee KL, Dabrowski R, Grayburn PA, Rajda M et al. Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial. Cardiovascular Ultrasound. 2020 May 28;18(1). 17. https://doi.org/10.1186/s12947-020-00195-1

Author

Kim, Kyung Hee ; She, Lilin ; Lee, Kerry L. ; Dabrowski, Rafal ; Grayburn, Paul A. ; Rajda, Miroslaw ; Prior, David L. ; Desvigne-Nickens, Patrice ; Zoghbi, William A. ; Senni, Michele ; Stefanelli, Guglielmo ; Beghi, Cesare ; Huynh, Thao ; Velazquez, Eric J. ; Oh, Jae K. ; Lin, Grace. / Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial. In: Cardiovascular Ultrasound. 2020 ; Vol. 18, No. 1.

BibTeX

@article{bc5588a99a1240cb9e0503d682d15047,
title = "Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial",
abstract = "Aims: We sought to determine which echocardiographic markers of left ventricular (LV) remodeling and diastolic dysfunction can contribute as incremental and independent prognostic information in addition to current clinical risk markers of ischemic LV systolic dysfunction in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Methods and results: The cohort consisted of 1511 of 2136 patients in STICH for whom baseline transmitral Doppler (E/A ratio) could be measured by an echocardiographic core laboratory blinded to treatment and outcomes, and prognostic value of echocardiographic variables was determined by a Cox regression model. E/A ratio was the most significant predictor of mortality amongst diastolic variables with lowest mortality for E/A closest 0.8, although mortality was consistently low for E/A 0.6 to 1.0. Mortality increased for E/A < 0.6 and > 1.0 up to approximately 2.3, beyond which there was no further increase in risk. Larger LV end-systolic volume index (LVESVI) and E/A < 0.6 and > 1.0 had incremental negative effects on mortality when added to a clinical multivariable model, where creatinine, LVESVI, age, and E/A ratio accounted for 74{\%} of the prognostic information for predicting risk. LVESVI and E/A ratio were stronger predictors of prognosis than New York Heart Association functional class, anemia, diabetes, history of atrial fibrillation, and stroke. Conclusions: Echocardiographic markers of advanced LV remodeling and diastolic dysfunction added incremental prognostic value to current clinical risk markers. LVESVI and E/A ratio outperformed other markers and should be considered as standard in assessing risks in ischemic heart failure. E/A closest to 0.8 was the most optimal filling pattern.",
keywords = "Diastolic dysfunction., Heart failure, Ischemic cardiomyopathy",
author = "Kim, {Kyung Hee} and Lilin She and Lee, {Kerry L.} and Rafal Dabrowski and Grayburn, {Paul A.} and Miroslaw Rajda and Prior, {David L.} and Patrice Desvigne-Nickens and Zoghbi, {William A.} and Michele Senni and Guglielmo Stefanelli and Cesare Beghi and Thao Huynh and Velazquez, {Eric J.} and Oh, {Jae K.} and Grace Lin",
year = "2020",
month = "5",
day = "28",
doi = "10.1186/s12947-020-00195-1",
language = "English (US)",
volume = "18",
journal = "Cardiovascular Ultrasound",
issn = "1476-7120",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Incremental prognostic value of echocardiography of left ventricular remodeling and diastolic function in STICH trial

AU - Kim, Kyung Hee

AU - She, Lilin

AU - Lee, Kerry L.

AU - Dabrowski, Rafal

AU - Grayburn, Paul A.

AU - Rajda, Miroslaw

AU - Prior, David L.

AU - Desvigne-Nickens, Patrice

AU - Zoghbi, William A.

AU - Senni, Michele

AU - Stefanelli, Guglielmo

AU - Beghi, Cesare

AU - Huynh, Thao

AU - Velazquez, Eric J.

AU - Oh, Jae K.

AU - Lin, Grace

PY - 2020/5/28

Y1 - 2020/5/28

N2 - Aims: We sought to determine which echocardiographic markers of left ventricular (LV) remodeling and diastolic dysfunction can contribute as incremental and independent prognostic information in addition to current clinical risk markers of ischemic LV systolic dysfunction in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Methods and results: The cohort consisted of 1511 of 2136 patients in STICH for whom baseline transmitral Doppler (E/A ratio) could be measured by an echocardiographic core laboratory blinded to treatment and outcomes, and prognostic value of echocardiographic variables was determined by a Cox regression model. E/A ratio was the most significant predictor of mortality amongst diastolic variables with lowest mortality for E/A closest 0.8, although mortality was consistently low for E/A 0.6 to 1.0. Mortality increased for E/A < 0.6 and > 1.0 up to approximately 2.3, beyond which there was no further increase in risk. Larger LV end-systolic volume index (LVESVI) and E/A < 0.6 and > 1.0 had incremental negative effects on mortality when added to a clinical multivariable model, where creatinine, LVESVI, age, and E/A ratio accounted for 74% of the prognostic information for predicting risk. LVESVI and E/A ratio were stronger predictors of prognosis than New York Heart Association functional class, anemia, diabetes, history of atrial fibrillation, and stroke. Conclusions: Echocardiographic markers of advanced LV remodeling and diastolic dysfunction added incremental prognostic value to current clinical risk markers. LVESVI and E/A ratio outperformed other markers and should be considered as standard in assessing risks in ischemic heart failure. E/A closest to 0.8 was the most optimal filling pattern.

AB - Aims: We sought to determine which echocardiographic markers of left ventricular (LV) remodeling and diastolic dysfunction can contribute as incremental and independent prognostic information in addition to current clinical risk markers of ischemic LV systolic dysfunction in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Methods and results: The cohort consisted of 1511 of 2136 patients in STICH for whom baseline transmitral Doppler (E/A ratio) could be measured by an echocardiographic core laboratory blinded to treatment and outcomes, and prognostic value of echocardiographic variables was determined by a Cox regression model. E/A ratio was the most significant predictor of mortality amongst diastolic variables with lowest mortality for E/A closest 0.8, although mortality was consistently low for E/A 0.6 to 1.0. Mortality increased for E/A < 0.6 and > 1.0 up to approximately 2.3, beyond which there was no further increase in risk. Larger LV end-systolic volume index (LVESVI) and E/A < 0.6 and > 1.0 had incremental negative effects on mortality when added to a clinical multivariable model, where creatinine, LVESVI, age, and E/A ratio accounted for 74% of the prognostic information for predicting risk. LVESVI and E/A ratio were stronger predictors of prognosis than New York Heart Association functional class, anemia, diabetes, history of atrial fibrillation, and stroke. Conclusions: Echocardiographic markers of advanced LV remodeling and diastolic dysfunction added incremental prognostic value to current clinical risk markers. LVESVI and E/A ratio outperformed other markers and should be considered as standard in assessing risks in ischemic heart failure. E/A closest to 0.8 was the most optimal filling pattern.

KW - Diastolic dysfunction.

KW - Heart failure

KW - Ischemic cardiomyopathy

UR - http://www.scopus.com/inward/record.url?scp=85085635663&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85085635663&partnerID=8YFLogxK

U2 - 10.1186/s12947-020-00195-1

DO - 10.1186/s12947-020-00195-1

M3 - Article

VL - 18

JO - Cardiovascular Ultrasound

T2 - Cardiovascular Ultrasound

JF - Cardiovascular Ultrasound

SN - 1476-7120

IS - 1

M1 - 17

ER -

ID: 63682304