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Association between systolic ejection time and outcomes in heart failure by ejection fraction

Priyesh A Patel1, Andrew P Ambrosy2,3, Matthew Phelan4

  • 1Sanger Heart and Vascular Institute, Atrium Health, Charlotte, NC, USA.

European Journal of Heart Failure
|December 22, 2019
PubMed

Insights

In heart failure patients, a longer systolic ejection time (SET) is linked to better outcomes in those with reduced ejection fraction (HFrEF). This finding suggests targeting SET could be a future therapy for HFrEF.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Worsening heart failure (HF) is often associated with a shorter left ventricular systolic ejection time (SET).
  • Limited data exist on the relationship between SET and clinical outcomes in ambulatory HF patients.
  • Understanding this relationship is crucial for identifying new therapeutic targets.

Purpose of the Study:

  • To investigate the association between SET and 1-year clinical outcomes in ambulatory patients with heart failure.
  • To compare SET and outcomes between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) populations.
  • To determine if SET is an independent predictor of adverse outcomes in different HF phenotypes.

Main Methods:

  • Retrospective analysis of 545 ambulatory HF patients (HFrEF and HFpEF) with outpatient echocardiograms.
  • Multivariable logistic regression was employed to assess the association between SET and 1-year composite outcomes (death or HF hospitalization).
  • Patient demographics, ejection fraction (EF), and echocardiographic parameters including SET were analyzed.

Main Results:

  • HFrEF patients had significantly shorter SET (280 ms) compared to HFpEF patients (315 ms).
  • The composite outcome of death or HF hospitalization occurred in 26.9% of HFrEF patients and 11.8% of HFpEF patients.
  • After multivariable adjustment, a longer SET was independently associated with lower odds of the composite outcome in HFrEF but not in HFpEF patients.

Conclusions:

  • Longer SET is independently associated with improved 1-year outcomes in patients with HFrEF.
  • The association between SET and outcomes was not significant in the HFpEF group.
  • Normalizing SET may represent a potential therapeutic strategy for patients with systolic dysfunction in heart failure.
Abstract

Keywords:
Ejection fractionHeart failureSystolic ejection timeSystolic function

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