ECHOCARDIOGRAPHY IN PATIENTS WITH HEART FAILURE: REDUCED AND PRESERVED LEFT VENTRICULAR FUNCTION: PP.1.14

Abstract

Introduction: Patients (pts) with heart failure (HF) can show reduced (r) or preserved (p) left ventricular ejection fraction (EF) and both these groups share the same morbility and mortality, even if there's still a tendency to consider more at stake pts with reduce EF. Objective: Our aim was to observe if pts with pEF or rEF show different echocardiographic geometric pattern and if there was any difference among E/A ratio, left ventricular isovolumetric time relaxation (IVRT) and deceleration time (DT) of early Doppler mitral valve flow velocity between the two groups. Methods and Results: We evaluated 205 consecutive pts with HF, defined by ACC/AHA guidelines, admitted to our Out-patients Clinic for the Management of Heart Failure after discharge from hospital where they had been admitted for acute HF. Each pts underwent echocardiography performed by the same operator. 119 pts were men and represent the 54% of pts with HF with pEF and the 71% of pts with HF with rEF. Average age was 70 ± 10 years (28–98) without significative differences in pts with or without pEF. HF ethiopathogenesis was due to hypertension in 95% of pts with pEF and 67% in pts with rEF.Concentric remodelling is the geometric pattern prevalent in pts with pEF whereas eccentric hypertrophy is more common among pts with rEF. If we analyse echocardiographic data in each different geometric pattern group, we find that in pts with normal geometry, DT is significantly reduced if EF<50 (0,22 ± 0,05 vs 0,16 ± 0,06, p < 0.05). We obtained similar results also when using RWT>0.42 as pathologic cut off value. Conclusions: Even if pts with pEF is mostly NYHA 0 or I in comparison to pts with rEF (mostly in NYHA II or III), they came from the same population of pts discharged from hospital with diagnosis of acute HF. These two different kinds of pts show a different echocardiographic geometric pattern.