Electromechanical activation time in the prediction of discharge outcomes in patients hospitalized with acute heart failure syndrome

Tze Fan Chao, Shih Hsien Sung, Hao Min Cheng, Wen Chung Yu, Kang Ling Wang, Chi Ming Huang, Chen Huan Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Objective Left ventricular systolic time intervals, including pre-ejection period (PEP), ejection time (ET), and their ratio (PEP/ET), is determined by systolic and diastolic function and ventriculo-arterial coupling. We investigated the usefulness of the electromechanical activation time [(EMAT) PEP minus isovolumic contraction time] in the prediction of cardiac mortality or re-hospitalization for heart failure in patients with the acute heart failure syndrome (AHFS). Patients and Methods A total of 45 patients (71.9±16.1 years old) hospitalized for AHFS were enrolled. Systolic time intervals and EMAT normalized by cardiac cycle length (%) were measured separately by separate automated acoustic devices. All parameters were assessed within 24 hours of admission, before discharge, and 2 weeks after discharge. Results During a mean follow-up of 242±156 days, 20 patients (44%) incurred adverse cardiovascular events including 18 re-hospitalizations for heart failure and 2 cardiovascular deaths. Using uni-variate Cox regression analysis, at admission %EMAT and %PEP, pre-discharge %EMAT, and post-discharge %EMAT significantly predicted post-discharge cardiovascular events with hazard ratios and 95% confidence intervals of 1.75(1.13-2.70), 1.67(1.02-2.70), 1.87 (1.10-3.17) and 2.50 (1.58-3.97) per 1-SD increment, respectively. The predictions remained significant after adjustment for age, sex, left ventricular ejection fraction, E/E ́ by Doppler echocardiography, and serum N-terminal pro-brain natriuretic peptide. Conclusion EMAT measured during the hospitalization course is useful in the prediction of cardiovascular outcomes in patients with AHFS independent of left ventricular ejection fraction, E/E ́, and serum N-terminal pro-brain natriuretic peptide.

Original languageEnglish
Pages (from-to)2031-2037
Number of pages7
JournalInternal Medicine
Volume49
Issue number19
DOIs
StatePublished - 2010

Keywords

  • Acute decompensated heart failure
  • Electromechanical activation time
  • Prognosis
  • Systolic time intervals

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