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Usefulness of systolic time intervals in the identification of abnormal ventriculo‐arterial coupling in stable heart failure patients*

2008; Elsevier BV; Volume: 10; Issue: 12 Linguagem: Inglês

10.1016/j.ejheart.2008.09.003

1879-0844

Hao‐Min Cheng, Wen‐Chung Yu, Shih‐Hsien Sung, Kangling Wang, Shao‐Yuan Chuang, Chen‐Huan Chen,

Pulmonary Hypertension Research and Treatments

Abstract Background: The ratio of effective arterial elastance (Ea) to ventricular end‐systolic elastance (Ees) indicates the status of ventriculo‐arterial coupling. Aims: We investigated if systolic time intervals (pre‐ejection period, PEP; ejection time, ET; and their ratio, PEP/ET) can be used to identify heart failure patients with abnormal ventriculo‐arterial coupling. Methods: Age and sex‐matched study subjects included 54 apparently healthy subjects with normal left ventricular (LV) function, and stable patients with LV diastolic ( n =54) and systolic dysfunction ( n =54). Ees and Ea were estimated non‐invasively by echocardiography, and abnormal ventriculo‐arterial coupling was defined as Ea/Ees>1.2. PEP, ET, and PEP/ET were measured automatically using electrocardiography, phonocardiography, and brachial pulse volume recording. Results: Ea/Ees>1.2 was present in 48.1% of subjects with systolic dysfunction. The PEP/ET was significantly associated with most parameters of LV structure and function, and Ea/Ees ( r =0.67, p <0.001). Using PEP/ET≥0.423 as cut point, the sensitivity and specificity to identify patients with Ea/Ees>1.2 were 85.7% and 84.3%, respectively for the whole population, and 84.6% and 78.6%, for patients with systolic dysfunction. Conclusion: Abnormal ventriculo‐arterial coupling was present in almost half of stable patients with systolic dysfunction. PEP/ET was useful in identifying such patients.