Long-term outcome of patients with triphasic mitral flow with a mid-diastolic L wave: prognostic role of left atrial volume and N-terminal pro-brain natriuretic peptide

Sung Ai Kim, Jungwoo Son, ChiYoung Shim, Eui Young Choi, Jong Won Ha

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

A mid-diastolic L wave has been recognized as a marker of advanced left ventricular (LV) diastolic dysfunction. However, its prognostic implication is unclear. This study assessed long-term prognosis and independent predictors of adverse outcomes in patients with a mid-diastolic L wave. A total of 144 consecutive patients (mean age 63 ± 12 years, 88 female) with a mid-diastolic L wave of ≥0.2 m/s and in sinus rhythm were identified. Patients with significant valvular heart disease, low LV ejection fraction and arrhythmias were excluded. Subjects were followed up for cardiovascular (CV) mortality and hospitalization for heart failure (HF). During follow-up for a median of 44 months (1–76), CV deaths and hospitalization for HF occurred in 41 (28%) patients. In multivariate Cox analysis, age (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.02–1.11; p = 0.001), log N-terminal pro-brain natriuretic peptide (NT-proBNP)(HR 3.81; 95% CI 1.78–8.15; p = 0.001), and left atrial volume index (HR 1.02; 95% CI 1.01–1.04; p = 0.019) were independent predictors of adverse outcomes in patients with a mid-diastolic L wave. In a stepwise model, NT-proBNP showed an incremental prognostic value for prediction of adverse outcomes when added to the clinical and echocardiographic parameters (Chi square from 30.1 to 41.1, p < 0.001). Patients with a mid-diastolic L wave and clinical, biochemical, and echocardiographic evidence of advanced diastolic dysfunction showed poor long-term clinical outcome.

Original languageEnglish
Pages (from-to)1377-1384
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume33
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

Fingerprint

Brain Natriuretic Peptide
Confidence Intervals
Hospitalization
Heart Failure
Heart Valve Diseases
Left Ventricular Dysfunction
Stroke Volume
Cardiac Arrhythmias
Multivariate Analysis
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{6a5f073016e84097b1ab991bc7347675,
title = "Long-term outcome of patients with triphasic mitral flow with a mid-diastolic L wave: prognostic role of left atrial volume and N-terminal pro-brain natriuretic peptide",
abstract = "A mid-diastolic L wave has been recognized as a marker of advanced left ventricular (LV) diastolic dysfunction. However, its prognostic implication is unclear. This study assessed long-term prognosis and independent predictors of adverse outcomes in patients with a mid-diastolic L wave. A total of 144 consecutive patients (mean age 63 ± 12 years, 88 female) with a mid-diastolic L wave of ≥0.2 m/s and in sinus rhythm were identified. Patients with significant valvular heart disease, low LV ejection fraction and arrhythmias were excluded. Subjects were followed up for cardiovascular (CV) mortality and hospitalization for heart failure (HF). During follow-up for a median of 44 months (1–76), CV deaths and hospitalization for HF occurred in 41 (28{\%}) patients. In multivariate Cox analysis, age (hazard ratio [HR], 1.07; 95{\%} confidence interval [CI], 1.02–1.11; p = 0.001), log N-terminal pro-brain natriuretic peptide (NT-proBNP)(HR 3.81; 95{\%} CI 1.78–8.15; p = 0.001), and left atrial volume index (HR 1.02; 95{\%} CI 1.01–1.04; p = 0.019) were independent predictors of adverse outcomes in patients with a mid-diastolic L wave. In a stepwise model, NT-proBNP showed an incremental prognostic value for prediction of adverse outcomes when added to the clinical and echocardiographic parameters (Chi square from 30.1 to 41.1, p < 0.001). Patients with a mid-diastolic L wave and clinical, biochemical, and echocardiographic evidence of advanced diastolic dysfunction showed poor long-term clinical outcome.",
author = "Kim, {Sung Ai} and Jungwoo Son and ChiYoung Shim and Choi, {Eui Young} and Ha, {Jong Won}",
year = "2017",
month = "9",
day = "1",
doi = "10.1007/s10554-017-1122-2",
language = "English",
volume = "33",
pages = "1377--1384",
journal = "International Journal of Cardiovascular Imaging",
issn = "1569-5794",
publisher = "Springer Netherlands",
number = "9",

}

Long-term outcome of patients with triphasic mitral flow with a mid-diastolic L wave : prognostic role of left atrial volume and N-terminal pro-brain natriuretic peptide. / Kim, Sung Ai; Son, Jungwoo; Shim, ChiYoung; Choi, Eui Young; Ha, Jong Won.

In: International Journal of Cardiovascular Imaging, Vol. 33, No. 9, 01.09.2017, p. 1377-1384.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcome of patients with triphasic mitral flow with a mid-diastolic L wave

T2 - prognostic role of left atrial volume and N-terminal pro-brain natriuretic peptide

AU - Kim, Sung Ai

AU - Son, Jungwoo

AU - Shim, ChiYoung

AU - Choi, Eui Young

AU - Ha, Jong Won

PY - 2017/9/1

Y1 - 2017/9/1

N2 - A mid-diastolic L wave has been recognized as a marker of advanced left ventricular (LV) diastolic dysfunction. However, its prognostic implication is unclear. This study assessed long-term prognosis and independent predictors of adverse outcomes in patients with a mid-diastolic L wave. A total of 144 consecutive patients (mean age 63 ± 12 years, 88 female) with a mid-diastolic L wave of ≥0.2 m/s and in sinus rhythm were identified. Patients with significant valvular heart disease, low LV ejection fraction and arrhythmias were excluded. Subjects were followed up for cardiovascular (CV) mortality and hospitalization for heart failure (HF). During follow-up for a median of 44 months (1–76), CV deaths and hospitalization for HF occurred in 41 (28%) patients. In multivariate Cox analysis, age (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.02–1.11; p = 0.001), log N-terminal pro-brain natriuretic peptide (NT-proBNP)(HR 3.81; 95% CI 1.78–8.15; p = 0.001), and left atrial volume index (HR 1.02; 95% CI 1.01–1.04; p = 0.019) were independent predictors of adverse outcomes in patients with a mid-diastolic L wave. In a stepwise model, NT-proBNP showed an incremental prognostic value for prediction of adverse outcomes when added to the clinical and echocardiographic parameters (Chi square from 30.1 to 41.1, p < 0.001). Patients with a mid-diastolic L wave and clinical, biochemical, and echocardiographic evidence of advanced diastolic dysfunction showed poor long-term clinical outcome.

AB - A mid-diastolic L wave has been recognized as a marker of advanced left ventricular (LV) diastolic dysfunction. However, its prognostic implication is unclear. This study assessed long-term prognosis and independent predictors of adverse outcomes in patients with a mid-diastolic L wave. A total of 144 consecutive patients (mean age 63 ± 12 years, 88 female) with a mid-diastolic L wave of ≥0.2 m/s and in sinus rhythm were identified. Patients with significant valvular heart disease, low LV ejection fraction and arrhythmias were excluded. Subjects were followed up for cardiovascular (CV) mortality and hospitalization for heart failure (HF). During follow-up for a median of 44 months (1–76), CV deaths and hospitalization for HF occurred in 41 (28%) patients. In multivariate Cox analysis, age (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.02–1.11; p = 0.001), log N-terminal pro-brain natriuretic peptide (NT-proBNP)(HR 3.81; 95% CI 1.78–8.15; p = 0.001), and left atrial volume index (HR 1.02; 95% CI 1.01–1.04; p = 0.019) were independent predictors of adverse outcomes in patients with a mid-diastolic L wave. In a stepwise model, NT-proBNP showed an incremental prognostic value for prediction of adverse outcomes when added to the clinical and echocardiographic parameters (Chi square from 30.1 to 41.1, p < 0.001). Patients with a mid-diastolic L wave and clinical, biochemical, and echocardiographic evidence of advanced diastolic dysfunction showed poor long-term clinical outcome.

UR - http://www.scopus.com/inward/record.url?scp=85016114068&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016114068&partnerID=8YFLogxK

U2 - 10.1007/s10554-017-1122-2

DO - 10.1007/s10554-017-1122-2

M3 - Article

C2 - 28349264

AN - SCOPUS:85016114068

VL - 33

SP - 1377

EP - 1384

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 9

ER -