Tissue Doppler Time Intervals Predict the Occurrence of Rehospitalization in Chronic Heart Failure: Data from the Daunia Heart Failure Registry

Abstract

Patients with chronic heart failure (HF) are often rehospitalized; rehospitalization identifies subjects with a poorer quality of life and a worse prognosis. Estimates of the time intervals by tissue Doppler imaging (TDI) in patients with chronic HF has not been fully investigated, despite recent studies having explored the prognostic role of TDI-derived parameters in major cardiac diseases, such as HF. We, therefore, aimed to assess the prognostic value of time intervals evaluated by TDI in patients with chronic HF. A total of 249 patients with chronic HF enrolled in the Daunia Heart Failure Registry underwent echocardiography assessment and were followed prospectively for a mean 284 ± 210 days. Conventional echocardiography and TDI parameters were calculated; time intervals were calculated by TDI: ST (systolic time), ET (ejection time), FT (filling time), and ICT (isovolumic contraction time). We also have calculated ICT/ET and tissue myocardial performance index ([ICT+IRT]/ET). At univariate analysis, ET (RR: 0.80, 95% confidence interval [CI] 0.71-0.90, P < 0.001), ST (RR: 0.88, 95% CI 0.78-0.99, P < 0.05), FT (RR: 0.88, 95% CI 0.78-0.99, P < 0.05), ICT/ET (RR: 1.21, 95% CI 1.07-1.37, P < 0.01) were related to the occurrence of rehospitalization during follow-up. At multivariate Cox regression analysis, correlations remained significant for ET and ST (P < 0.05 and P < 0.01, respectively). Time intervals assessed by TDI may be helpful in predicting the risk of rehospitalization in subjects with chronic HF.