Abstract 13764: Prognostic Value of a Novel Echocardiographic Risk Score for Long-Term Clinical Outcomes in Patients With Ischemic Heart Failure

Abstract

Introduction: Two-dimensional-echocardiography (2DE) derived global longitudinal strain (GLS) could predict outcome in patients with heart failure. Mitral annular plane systolic excursion (MAPSE) derived from M-mode echocardiography is a classical indicator of clinical outcome in heart failure patients. Hypothesis: This study aimed to compare the prognostic performance of GLS and MAPSE as well as a new echocardiographic risk score for the prediction of mortality and cardiovascular (CV) rehospitalization risk in ischemic heart failure (IHF) patients with reduced left ventricular ejection fraction (LVEF). Methods: This retrospective observational study comprised 1277 IHF patients with reduced LVEF (<50%) receiving echocardiography including GLS. All patients completed at least one-year clinical follow-up by telephone interview or clinical visit. The primary endpoints included all-cause death, heart transplantation, CV death, or rehospitalization. Measures were used to develop a novel risk score for clinical outcome. Results: After adjusted for age, sex, and other clinical risk factors, lower LVEF (≤30% vs. >30%, HR=1.39 and 1.53, P=0.005 and 0.002), lower MAPSE (≤7 vs. >7mm, HR=1.35 and 1.35, P=0.007 and P=0.021), or lower GLS (≤8.4% vs. >8.4%, HR=1.31 and 1.51, P=0.012 and 0.001) remained as independent predictors for overall and CV mortality, but not for CV rehospitalization. Prediction efficacy of a new echocardiographic risk score including multiple echocardiographic parameters, including systolic dysfunction (LVEF, MAPSE, or GLS), diastolic dysfunction, LV remodeling, and right-side cardiac dysfunction (right ventricular diameter and systolic pulmonary artery pressure) was tested stratifying low, intermediate, and high risk. Patients with high-risk score faced both significantly higher risk of overall mortality (HR=1.99 or 1.42) CV mortality (HR=2.15 or 1.60), and CV rehospitalization risk (HR=2.01 or 1.43) as compared patients with low or intermediate risk score (all P<0.05). Conclusions: The new echocardiographic risk score derived from multiple echocardiographic indicators is associated with satisfactory prognostic performance on both mortality and CV rehospitalization.