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Echocardiographic predictors of late mortality in elderly patients with acute coronary syndromes

Avinoam Shiran1, Salim Adawi, Idit Dobrecky-Mery

  • 1Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel.

The Israel Medical Association Journal : IMAJ
|May 12, 2007
PubMed

Insights

Echocardiographic measurements of systolic and diastolic left ventricular (LV) function are valuable for predicting long-term survival in elderly patients with acute coronary syndromes (ACS). A restrictive LV filling pattern emerged as the strongest independent predictor of mortality in this population.

Area of Science:

  • Cardiology
  • Geriatrics
  • Diagnostic Imaging

Background:

  • Echocardiographic ventricular function is crucial for prognosis and management in acute coronary syndromes (ACS).
  • Assessing diastolic left ventricular (LV) function via echocardiography can be challenging in elderly patients.

Purpose of the Study:

  • To evaluate the predictive value of echocardiographic systolic and diastolic LV function measurements for long-term outcomes in elderly patients with ACS.
  • To identify key echocardiographic parameters influencing survival and rehospitalization rates.

Main Methods:

  • Study included 142 elderly patients (≥70 years) with ACS, who underwent echocardiography during hospitalization.
  • Left ventricular ejection fraction (LVEF) and diastolic mitral inflow patterns were analyzed.
  • Outcomes assessed included survival and repeat hospitalization over 18-24 months.

Main Results:

  • A lower LVEF (<40%) was associated with reduced 2-year survival (61% vs. 81%, P=0.038).
  • Severe diastolic dysfunction (restrictive filling pattern) significantly lowered survival rates (43% vs. 76%, P=0.009).
  • A restrictive filling pattern was the strongest independent predictor of mortality (HR 4.6), followed by heart failure diagnosis and older age.

Conclusions:

  • Echocardiographic systolic and diastolic LV function measurements effectively predict long-term survival in elderly ACS patients.
  • A restrictive filling pattern is a powerful independent predictor of mortality in this demographic.
  • Neither LVEF nor restrictive filling pattern predicted repeat hospitalizations.
Abstract

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