Prognostic and diagnostic value of tissue Doppler in patients with systolic heart failure

摘要: Heart failure (HF) is a condition where the heart fails to meet need of delivery oxygen and energy tissues. In spite advances in recent decades, prognosis still serious with mortality risk comparable severe cancer. The most common imaging method today ultrasound heart, or echocardiography. HF affected by several factors. last two diastolic function right ventricle (RV) have been shown be important for HF. The purpose present thesis was evaluate diagnostic prognostic properties relatively new echocardiographic method, tissue Doppler (TDI). TDI measures velocities myocardial throughout cardiac cycle. It has simple, sensitive reproducible systolic left (LV) RV. Another aim examine power performance index (MPI), based index, calculated as sum isovolumic time intervals divided ejection time. 173 patients admitted Department Cardiology at Sodersjukhuset (Stockholm General South Hospital) due acute reduced (LV fraction, LVEF ≤ 40%) were included study. Echocardiography performed measured 4 sites LV RV free wall. We studies (Papers I V), three (Paper II-IV). Study 126 sinus rhythm evaluated conventional methods, so called transmitral blood flow. Almost one third had pattern on flow that could not distinguished from normal function, but showed vast majority these dysfunction. With TDI, assessed all patients. Paper V, 41 newly diagnosed examined again after 3-6 months when medication titrated adequate doses. At follow-up, parameters improved, hardly changed all. II-III, value studied. shorter follow-up period, variable E/e‟, non-invasive measure sided filling pressure, an independent predictor cardiovascular (CV) during study period (HR 3.8, p 0.014). III, longer, parameter (the velocities) found only associated combined end-point CV hospitalization. In IV, we TDI-derived MPI extremely powerful tool predict longer term. Having > 0.67 indicated 13-fold increased mortality. In conclusion, highly feasible assess cardiac…