Peak Myocardial Acceleration during Isovolumic Relaxation Time Predicts the Occurrence of Rehospitalization in Chronic Heart Failure: Data from the Daunia Heart Failure Registry.

Background Tissue Doppler imaging ( TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure ( CHF). The clinical role of new developed TDI parameters, however, still needs to be documented. Methods A total of 113 consecutive patients with CHF enrolled in the Daunia heart failure registry underwent echocardiography assessment and were followed prospectively for 234 ± 262 days. Conventional echocardiography and TDI parameters were calculated. We also calculated peak myocardial acceleration during isovolumic relaxation time ( pIVA[r]) derived from TDI ( pIVV(r)/AT). Results Subjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8 ± 0.3 vs. 1.3 ± 0.5 m/s2, P < 0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow-up (HR 0.78, 95% confidence interval 0.64-0.96, P < 0.05), even after multivariable analysis. The assessment of pIVA(r) in addition to left ventricular ejection fraction (LVEF) and E/E′ provided additional prognostic value (Log Rank P < 0.05). The presence of abnormal pIVA(r), LVEF, and E/E′ levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow-up than those with 2 abnormal marker levels or 0-1 (Log Rank P < 0.05). Conclusions Peak myocardial acceleration during isovolumic relaxation time may represent an independent adjunctive tool for the risk stratification of patients with CHF. [ABSTRACT FROM AUTHOR]