Left Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value

• DOI: 10.1111/echo.70109
• Publication Date: 2025-02-20T07:50:49Z
• Authors: Frank L. Dini; Valentina Barletta; Piercarlo Ballo; Giovanni Cioffi; Nicola Riccardo P...; Andrea Rossi; Gani Bajraktari; Stefano Ghio; Michael Y. Henein
• Keywords: Interquartile range; Ventricular outflow tract; Univariate analysis

ABSTRACT Background and Aims The assessment of left ventricular (LV) outflow velocity time integral (LVOT‐VTI) has gained favor in the stratification patients with heart failure (HF). We evaluated prognostic significance LVOT‐VTI compared commonly used indices LV outflow: cardiac index (CI) stroke volume (SVI), their reproducibility cut‐off values. Methods Results A total 424 outpatients diagnosed HF systolic dysfunction (LV ejection fraction < 50%) underwent a Doppler echocardiographic examination, including CI, SVI, LVOT‐VTI. Bland–Altman analysis showed most reproducible index. study follow‐up duration was 3.5 years (interquartile range 1.6–6.5), at end which there were 94 cardiovascular deaths (29%). Cox regression univariate that predictive end‐point. ratio tricuspid annular displacement‐to‐pulmonary artery pressure (TAPSE/PASP) ( p 0.0001), = 0.0011), end‐systolic 0.0036) independently predicted At receiver‐operating characteristic (ROC) analysis, 12.0 cm had best sensitivity specificity for predicting mortality. Reduced EF raised BNP levels 0.0053), high filling 0.044) associated low multivariate logistic analysis. Patients TAPSE/PASP 0.32 mm/mmHg exhibited worst prognosis on Kaplan–Meier survival curves 0.0001). Conclusions represents predictor outcome proved forward flow chronic dysfunction. combination impaired survival.