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Prognostic value of real-time three-dimensional echocardiography compared to two-dimensional echocardiography in patients with systolic heart failure

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Abstract

Heart failure (HF) is associated with morbidity and mortality. Real-time three-dimensional echocardiography (RT3DE) may offer additional prognostic data in patients with HF. The study aimed to evaluate the prognostic value of real-time three-dimensional echocardiography (RT3DE). This is a prospective study that included 89 patients with HF and left ventricular ejection fraction (LVEF) < 0.50 who were followed for 48 months. Left atrium and ventricular volumes and functions were evaluated by RT3DE. TDI and two-dimensional echocardiography parameters were also obtained. The endpoint was a composite of death, heart transplantation and hospitalization for acute decompensated HF. The mean age was 55 ± 11 years, and the LVEF was 0.32 ± 0.10. The composite endpoint occurred in 49 patients (18 deaths, 30 hospitalizations, one heart transplant). Patients with outcomes had greater left atrial volume (40 ± 16 vs. 32 ± 12 mL/m2; p < 0.01) and right ventricle diameter (41 ± 9 vs. 37 ± 8 mm, p = 0.01), worse total emptying fraction of the left atrium (36 ± 13% vs. 41 ± 11%; p = 0.03), LVEF (0.30 ± 0.09 vs. 0.34 ± 0.11; p = 0.02), right ventricle fractional area change (34.8 ± 12.1% vs. 39.2 ± 11.3%; p = 0.04), and greater E/e′ ratio (19 ± 9 vs. 16 ± 8; p = 0.04) and systolic pulmonary artery pressure (SPAP) (50 ± 15 vs. 36 ± 11 mmHg; p < 0.01). In multivariate analysis, LVEF (OR 4.6; CI 95% 1.2–17.6; p < 0.01) and SPAP (OR 12.5; CI 95% 1.8–86.9; p < 0.01) were independent predictors of patient outcomes. LVEF and the SPAP were independent predictors of outcomes in patients with HF.

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Abbreviations

2Decho:

Two-dimensional echocardiography

HF:

Heart failure

LA:

Left atrial

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

RT3DE:

Real-time three-dimensional echocardiography

RV:

Right ventricular

TDI:

Tissue Doppler imaging

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Authors and Affiliations

  1. Cardiology Department, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Rua Domiciano Leite Ribeiro 51, Apt 13, Bloco 2, Sao Paulo, SP, 04317-000, Brazil

    Frederico J. N. Mancuso, Valdir A. Moises, Dirceu R. Almeida, Luciana J. Storti, Flavio S. Brito, Angelo A. V. de Paola, Antonio C. C. Carvalho & Orlando Campos

  2. Sleep Institute, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Sao Paulo, Brazil

    Dalva Poyares, Luciana J. Storti & Sergio Tufik

Authors
  1. Frederico J. N. Mancuso
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  2. Valdir A. Moises
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  3. Dirceu R. Almeida
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  8. Angelo A. V. de Paola
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  9. Antonio C. C. Carvalho
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Correspondence to Frederico J. N. Mancuso.

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Mancuso, F.J.N., Moises, V.A., Almeida, D.R. et al. Prognostic value of real-time three-dimensional echocardiography compared to two-dimensional echocardiography in patients with systolic heart failure. Int J Cardiovasc Imaging 34, 553–560 (2018). https://doi.org/10.1007/s10554-017-1266-0

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