Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Abstract Objective We sought to evaluate the short-term prognostic value of echocardiography including two-dimensional (2D) strain imaging in patients with end-stage idiopathic dilated cardiomyopathy (IDCM). Methods To evaluate the short-term (6-month) prognostic value of different parameters used f...

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Bibliographic Details
Published in:Transplantation proceedings 2009, Vol.41 (1), p.277-280
Main Authors: Jasaityte, R, Dandel, M, Lehmkuhl, H, Hetzer, R
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiology. Vascular system
Cardiomyopathy, Dilated - diagnostic imaging
Cardiomyopathy, Dilated - physiopathology
Cardiomyopathy, Dilated - therapy
Diastole
Disease Progression
Echocardiography
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Heart
Heart Failure
Heart-Assist Devices
Humans
Medical sciences
Middle Aged
Myocarditis. Cardiomyopathies
Predictive Value of Tests
Sensitivity and Specificity
Stroke Volume
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Systole
Tissue, organ and graft immunology
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Summary:Abstract Objective We sought to evaluate the short-term prognostic value of echocardiography including two-dimensional (2D) strain imaging in patients with end-stage idiopathic dilated cardiomyopathy (IDCM). Methods To evaluate the short-term (6-month) prognostic value of different parameters used for the assessment of IDCM patients referred for heart transplantation, we performed at the baseline transthoracic echocardiography including 2D strain imaging, N-terminal pro-BNP measurements, and exercise testing for all patients included in the study. After 6 months, all parameters, including endsystolic strain (ESS), peak systolic strain rate (SSRmax ), early and late diastolic strain rates, their ratio (diastolic strain rate E [DSRE ], dialostolic strain rate A [DSRA ], diastolic strain rate E and A wave ratio [DSRE/A ]), and systolic intraventricular dyssynchrony indexes (IVDSI) were tested for their prognostic value to predict a patient's outcome. Results At the baseline stable patients had significantly lower transmitral E and A wave ratio (E/A), DSRE/A , higher DSRA values, longer transmitral E wave deceleration time (DcT), higher longitudinal ESS and SSRmax values, lower systolic circumferential and longitudinal IVDSI. Conclusion The highest sensitivity for rapid heart failure progression was shown by DcT 1.5, DSRA < 0.3/s, circumferential IVDSI > 0.16, and longitudinal IVDSI > 0.22 (91%, 78%, 94%, 83%, and 75%, respectively).
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.10.083