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Echocardiographic ejection fraction in patients with acute heart failure: correlations with hemodynamic, clinical, and neurohormonal measures and short-term outcome.

AbstractBACKGROUND:
Although echocardiographic ejection fraction (EF) is frequently used for the estimation of left ventricular contractility in patients with acute heart failure, its exact role and correlations with clinical, hemodynamic, and neurohormonal variables of cardiac contractility is not known.
METHODS:
Patients (343) with acute heart failure, enrolled into two prospective placebo-controlled hemodynamic studies of tezosentan, and in whom EF was available at baseline, were included. Outcome was evaluated in a subset of 94 patients who were enrolled in the placebo arms of the studies.
RESULTS:
Higher echocardiographic EF was correlated with older age, increased incidence of hypertension and atrial fibrillation, and female gender. We observed weak correlation between EF and cardiac output or cardiac power and no correlation with wedge pressure, and the change in hemodynamic variables over time. Higher EF was correlated with more baseline leukocytosis and higher plasma levels of endothelin-1 and blood urea nitrogen, while lower EF was related to higher baseline B-type natriuretic peptide (BNP). We observed no overall correlations between EF and outcome.
CONCLUSIONS:
In patients with acute heart failure, echocardiographic EF is weakly correlated with hemodynamic measures of left ventricular contractility and outcome; hence, it should be interpreted cautiously when evaluating patients admitted due to acute heart failure.
AuthorsNir Uriel, Guillermo Torre-Amione, Olga Milo, Edo Kaluski, Loïc Perchenet, Alex Blatt, Isaac Kobrin, Arkadi Turnovski, Shoshana Kaplan, Maurizio Rainisio, Aline Frey, Zvi Vered, Gad Cotter
JournalEuropean journal of heart failure (Eur J Heart Fail) Vol. 7 Issue 5 Pg. 815-9 (Aug 2005) ISSN: 1388-9842 [Print] England
PMID16087136 (Publication Type: Journal Article)
Chemical References
  • Endothelin-1
Topics
  • Aged
  • Blood Urea Nitrogen
  • Cardiac Output
  • Endothelin-1 (blood)
  • Female
  • Heart Failure (diagnostic imaging, physiopathology)
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Retrospective Studies
  • Stroke Volume
  • Treatment Outcome
  • Ultrasonography

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