Risk stratification with echocardiographic biomarkers in heart failure with preserved ejection fraction: the media echo score

• DOI: 10.1002/ehf2.13251
• Publication Date: 2021-03-03T13:45:05Z
• Authors: Olivier Huttin; Alan G. Fraser; Lars H. Lund; Erwan Donal; Cecilia Linde; Masatake Kobayashi; Tamas Erdei; Jean‐Loup Machu; Kevin Duarte; Patrick Rossignol; Walter Paulus; Faiez Zannad; Nicolas Girerd
• Keywords: Heart Failure; Diastolic function; Heart failure; Stroke Volume; Preserved ejection fraction; Risk Assessment; Risk prediction; [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; 3. Good health; diastolic; 03 medical and health sciences; Cardiovascular diseases; 0302 clinical medicine; [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; Echocardiography; RC666-701; Original Research Articles; Diseases of the circulatory (Cardiovascular) system; Humans; Prospective Studies; Heart failure, diastolic; Biomarkers; Cardiac oedema

Abstract Aims Echocardiographic predictors of outcomes in heart failure with preserved ejection fraction (HFpEF) have not been systematically or independently validated. We aimed at identifying echocardiographic cardiovascular events a large cohort patients HFpEF and to validate these an independent cohort. Methods results assessed the association between parameters 515 left ventricular (LV) (>50%) MEtabolic Road DIAstolic Heart Failure (MEDIA) multicentre study. validated out findings 286 from Karolinska‐Rennes Prospective Study (KaRen). After multiple adjustments including N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), significant death hospitalization were pulmonary arterial systolic pressure > 40 mmHg, respiratory variation inferior vena cava diameter 0.5, E/e' 9, lateral mitral annular s' < 7 cm/s. The combination four variables differentiated <10% vs. >35% 1 year risk. Adding on top clinical NT‐proBNP yielded net reclassification improvement (33.8%, P 0.0001) increase C‐index (5.3%, change 72.2% 77.5%, = 0.015) similar magnitude as addition alone. In KaRen cohort, (22.3%, 0.014) (4.0%, 0.029). Conclusions Use simple (within MEDIA echo score), indicative hypertension, elevated central venous pressure, LV diastolic dysfunction, long‐axis predicted prognosis improved risk stratification additionally HFpEF. This finding was