TY - JOUR
T1 - Does left ventricular shape influence clinical outcome in heart failure?
AU - Harjai, Kishore J.
AU - Edupuganti, Ravindra
AU - Nunez, Eduardo
AU - Turgut, Tansel
AU - Scott, Luis
AU - Pandian, Natesa G.
PY - 2000
Y1 - 2000
N2 - Background: Left ventricular (LV) shape tends to become spherical in patients with dilated cardiomyopathy of diverse etiology. Clinical and echocardiographic factors which affect the degree of LV spherical distortion and the impact of altered LV shape on prognosis have not been studied adequately. Hypothesis: This study was undertaken to investigate the prognostic implications of altered LV shape on clinical outcome in dilated cardiomyopathy. Methods: In 112 patients with depressed LV ejection fraction (19 ± 9%) and symptomatic heart failure, and in 10 age- and gender-matched normal controls, we performed 2-dimensional echocardiography to assess LV shape using the eccentricity index. Eccentricity index was defined as the ratio of the LV long axis to the LV transverse diameter, measured at end systole and end diastole in the apical four-chamber view. We sought univariate and multivariate clinical and echocardiographic correlates of LV shape. Further, we sought correlations between eccentricity index and clinical outcomes (death and composite outcome of death or emergent heart transplant). Results: Compared with controls, patients with cardiomyopathy had significantly lower systolic (2.04 vs. 1.56; p = 0.001) and diastolic (1.75 vs. 1.53; p = 0.003) eccentricity index, implying a more spherical LV shape. Of all clinical and echocardiographic variables tested, mitral regurgitation, right ventricular dysfunction, and increased LV mass were independently associated with spherical LV shape. At a follow-up period of 17 ± 12 months, no correlation was found between eccentricity index and the occurrence of death or the combined endpoint of death or emergent heart transplant, in univariate or multivariate analysis. Conclusions: In patients with dilated cardiomyopathy, the degree of spherical distortion of the LV does not correlate with prognosis.
AB - Background: Left ventricular (LV) shape tends to become spherical in patients with dilated cardiomyopathy of diverse etiology. Clinical and echocardiographic factors which affect the degree of LV spherical distortion and the impact of altered LV shape on prognosis have not been studied adequately. Hypothesis: This study was undertaken to investigate the prognostic implications of altered LV shape on clinical outcome in dilated cardiomyopathy. Methods: In 112 patients with depressed LV ejection fraction (19 ± 9%) and symptomatic heart failure, and in 10 age- and gender-matched normal controls, we performed 2-dimensional echocardiography to assess LV shape using the eccentricity index. Eccentricity index was defined as the ratio of the LV long axis to the LV transverse diameter, measured at end systole and end diastole in the apical four-chamber view. We sought univariate and multivariate clinical and echocardiographic correlates of LV shape. Further, we sought correlations between eccentricity index and clinical outcomes (death and composite outcome of death or emergent heart transplant). Results: Compared with controls, patients with cardiomyopathy had significantly lower systolic (2.04 vs. 1.56; p = 0.001) and diastolic (1.75 vs. 1.53; p = 0.003) eccentricity index, implying a more spherical LV shape. Of all clinical and echocardiographic variables tested, mitral regurgitation, right ventricular dysfunction, and increased LV mass were independently associated with spherical LV shape. At a follow-up period of 17 ± 12 months, no correlation was found between eccentricity index and the occurrence of death or the combined endpoint of death or emergent heart transplant, in univariate or multivariate analysis. Conclusions: In patients with dilated cardiomyopathy, the degree of spherical distortion of the LV does not correlate with prognosis.
KW - Heart failure
KW - Left ventricular shape
KW - Prognosis
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U2 - 10.1002/clc.4960231130
DO - 10.1002/clc.4960231130
M3 - Article
C2 - 11097127
AN - SCOPUS:0033767205
SN - 0160-9289
VL - 23
SP - 813
EP - 819
JO - Clinical Cardiology
JF - Clinical Cardiology
IS - 11
ER -