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Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure.
- Source :
-
Journal of the American College of Cardiology [J Am Coll Cardiol] 2002 Jun 05; Vol. 39 (11), pp. 1787-95. - Publication Year :
- 2002
-
Abstract
- Objectives: We sought to investigate whether pseudonormal (PN) filling was associated with death or hospital admission in patients with congestive heart failure (CHF).<br />Background: The high mortality rate associated with CHF is related to many clinical and echocardiographic variables. In particular, a short mitral deceleration time and restrictive diastolic filling predict death and/or hospital admission. We hypothesized that differentiating patients with nonrestrictive filling might identify an intermediate PN group that may be associated with intermediate risk.<br />Methods: A total of 115 patients admitted to the hospital for exacerbation of CHF symptoms underwent pre-discharge Doppler echocardiography to determine mitral inflow (before and after preload reduction) and pulmonary venous return. Patients were followed up for one year, and all-cause mortality and re-admission data were analyzed.<br />Results: The classification of filling patterns was: abnormal relaxation (AR) in 46 (40%) patients, pseudonormal (PN) filling in 42 (36.5%) patients and restrictive filling pattern (RFP) in 27 (23.4%) patients. When comparing the RFP group with the AR group, all-cause mortality was higher (38.4% vs. 17.4%, p = 0.033), hospital admission was higher (70.3% vs. 54.3%, p = 0.073), death/hospital admission was higher (77.8% vs. 56.5%, p = 0.02), CHF hospital admission was higher (40.7% vs. 15.2%, p = 0.01) and death/CHF hospital admission was higher (62.9% vs. 26.1%, p = 0.0005). Mortality in the PN group was not significantly different from that in the two other groups, but re-admissions were higher than the AR group (76.2% vs. 54.3%, p = 0.006), as was death/re-admission (78.6% vs. 56.5%, p = 0.004) and death/CHF re-admission (47.6% vs. 26.1%, p = 0.03). Re-admissions in the PN and RFP groups were comparable.<br />Conclusions: In a general hospital population of older patients with CHF, PN filling was associated with hospital admission rates similar to those seen with restrictive filling. The combined end point of death/CHF hospital admission was similar for restrictive filling and AR. Measurement of these variables is easy to add to routine clinical echocardiography and may provide important prognostic information in a wide range of patients with CHF.
- Subjects :
- Aged
Diastole
Disease-Free Survival
Echocardiography, Doppler, Pulsed
Heart Failure diagnostic imaging
Heart Failure mortality
Hospitalization statistics & numerical data
Humans
Mitral Valve diagnostic imaging
Prognosis
Ventricular Function, Left
Heart Failure physiopathology
Mitral Valve physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0735-1097
- Volume :
- 39
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 12039492
- Full Text :
- https://doi.org/10.1016/s0735-1097(02)01868-5