Strategic Multimodal Non-Invasive Assessment of Cardiac Performance in Patients with Heart Failure
Authors' conclusion
The combination of NT-proBNP and Echo-LVFP could be used to predict adverse outcomes in patients with HF of various stages. Left atrial mechanics and exercise capacity are incremental to prognostication.
Study context
- Population
- Consecutive hospitalized stage A-C heart failure (HF) patients evaluated with NT-proBNP, echocardiography incl. 2D speckle tracking, and cardiopulmonary exercise testinganalysed
- Participants
- 224 participants
- Exposure
- Left ventricular filling pressure (LVFP) groups by NT-proBNP and echocardiographic LVFP grading
- Group 1n = 123reference
- Group 2n = 56
- Group 3n = 45
- Outcome
- Adverse outcome: composite of CV death, non-fatal ACS, acute stroke, or HF-related hospitalization
- Follow-up
- 18.6 ± 9.8 months
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Event-free survival
Event-free survival in Group 2 better than Group 3 but worse than Group 1
log-rank P < 0.001
Observational data: associations, not effects.
Further findings
Predictors of adverse outcome
- Mechanical left atrial dysfunction (peak longitudinal strain <28%), adjusted HR
- 5.69 (95% CI 1.06-4.48)
- Limited exercise capacity (peak VO2 per +5 mL/kg/min), adjusted HR
- 0.63 (95% CI 0.46-0.87)
- Serial addition of peak VO2 and left atrial strain incrementally enhanced predictive power of LVFP-based risk stratification
- HR 5.69 is printed outside its CI 1.06-4.48, as printed
Original publication
Strategic Multimodal Non-Invasive Assessment of Cardiac Performance in Patients with Heart Failure. ESC Heart Fail. Published 13 June 2023. doi:10.
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