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
Summary
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.
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