Mitral peak early diastolic filling velocity to deceleration time ratio as a predictor of prognosis in patients with chronic heart failure and preserved or reduced ejection fraction

Objective Doppler derived mitral peak early diastolic filling velocity to deceleration time ratio(E/DT) has been proposed as parameter for predicting prognosis in general population.This study prospectively investigates the incremental prognostic value of E/DT over clinical,conventional echocardiographic and mitral-Doppler variables in patients hospitalized for decompensated heart failure(HF).Methods We analyzed 95 HF patients(mean age 64.8 ± 12.2 years) hospitalized at our institution from January 2010 to March 2012.The primary end-point was cardiac death or hospitalization,whichever occurred first.Cox regression analysis was performed to identify significant predictors of outcomes.Results During follow-up(median 37.7 months) 13 patients died and 44 were hospitalized for a cardiac event.At univariable analysis,New York Heart Association(NYHA) functional class,furosemide dosage,lateral tricuspidal annular plane systolic excursion,deceleration time and E/DT were predictive of outcome.At multivariable analysis,E/DT was the only predictor of prognosis(hazard ratio = 1.02,P = 0.018),giving incremental prognostic information to clinical and other echocardio-graphic measures(global chi-square from 15.4 to 25.2;P = 0.032).Conclusions E/DT gives independent and incremental prognostic information in HF patients.