Prognostic Value of Tricuspid Annular Tissue Doppler Velocity in Heart Failure with Atrial Fibrillation
- Affiliated Author(s)
- 김형섭; 정치영; 윤혁준; 박형섭; 조윤경; 남창욱; 허승호; 김윤년; 김권배
- Alternative Author(s)
- Kim, Hyung Seop; Jung, Chi Young; Yoon, Hyuck Jun; Park, Hyoung Seob; Cho, Yun Kyeong; Nam, Chang Wook; Hur, Seung Ho; Kim, Yoon Nyun; Kim, Kwon Bae
- Journal Title
- Journal of the American Society of Echocardiography
- ISSN
- 0894-7317
- Issued Date
- 2012
- Keyword
- Heart failure; Atrial fibrillation; Doppler tissue imaging; Tricuspid valve; Mitral valve
- Abstract
- Background: Right ventricular function is associated with long-term outcomes of heart failure (HF), particularly
with atrial fibrillation (AF). The aim of this study was to evaluate the prognostic value of Doppler tissue imaging
at the mitral and tricuspid annuli in patients with HF and AF.
Methods: In this prospective observational study, 457 patients (mean age, 67 years; 283 men) referred for HF
with AF were enrolled and underwent conventional echocardiography including pulsed-wave Doppler tissue
imaging. Systolic (s0) and early diastolic (e0) velocities of the tricuspid and mitral annuli were recorded from the
apical four-chamber view. The development of clinical adverse events during the follow-up period was defined
as the composite of cardiac death and readmission for HF.
Results: During the follow-up period (median, 20 months), 37 patients reached the primary end point (nine
deaths and 28 cases of HF). Patients with cardiac events were significantly older and more often had previous
HF admissions and diuretic use, higherNew York Heart Association classes, and greater average ratios of peak
early diastolic mitral inflow to annular velocity. Additionally, Doppler tissue imaging of s0 and e0 at the tricuspid,
septal, and lateral mitral annuli were all reduced. Multivariate analysis showed that tricuspid s0 and septal e0
remained significant predictors of cardiac events. By Kaplan-Meier analysis, the occurrence of cardiac events
was more frequent when tricuspid s0 was <9.0 cm/sec (P < .001) and when septal e0 was <7.3 cm/sec (P < .001).
Conclusions: In patients with HF and AF with a high risk for cardiac events, tricuspid s0 and septal e0 can be
independent risk predictors of outcomes.
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